Preliminary Experience in the Use of an Extracellular Matrix (CorMatrix) as a Tube Graft: Word of Caution
Section snippets
Clinical Data
The study was approved by the Institutional Review Board at Nationwide Children׳s Hospital. The data were retrospectively collected from patients who underwent cardiac surgery using CorMatrix as an interposition graft from May 2012 to May 2013. Demographic and clinical data such as cardiac diagnosis, echocardiography, and cardiac catheterization results were reviewed.
Surgery
The CorMatrix patch was wrapped around a Hegar dilator of the required size while the edge was sutured with 7-0 PROLENE (PROLENE,
Results
A total of 13 patients underwent cardiac surgery using CorMatrix conduit as an interposition graft.
Of these patients, the grafts were used for central PA reconstruction in comprehensive stage II surgery for hypoplastic left-sided heart syndrome in 10 patients (Supplementary Table 1). Sudden death occurred in 2 patients at home due to unknown causes after stage II surgery. Of the 8 surviving patients, 4 underwent the Fontan procedure, and the other 4 patients are waiting for it. The average
Discussion
Core matrix is made from subintestinal mucosa (SIS) and has been used extensively as an ECM, especially for reconstruction of various tissues such as the abdominal wall, urinary bladder wall, tendons, intestine wall tissue, urethra, and ureter.11 CorMatrix has recently been used in cardiac surgery for intraventricular septal repair,12 myocardial regeneration,13 valvuloplasty,9 or angioplasty as a patch.7, 14 The use of CorMatrix in congenital heart disease has also been reported recently.8, 10,
Conclusion
Although angioplasty using CorMatrix as an interposition tube vascular graft demonstrated no adverse event in the aortic position in short term, a high rate of intimal hyperplasia formation with significant stenosis was found in the venous circulation. Longer-term follow-up is required to assess the potential for growth of an arterial conduit. CorMatrix may not be the ideal conduit material in the low-pressure small-diameter system in children to provide long-term durable outcomes.
Conflict of Interest
Patrick McConnell
Grant/Research Support—CorMatrix cardiovascular, Inc; Thoratec Corporation
Consultant—Q test Laboratories; Clear Catheter Systems, Inc
Toshiharu Shinoka
Grant or Research Support—Gunze, Inc
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2019, BiomaterialsCitation Excerpt :Clinical use of Cormatrix has been introduced since 2006 for pericardial closure and cardiac tissue repair with encouraging early results. [31] However, recent evidence suggest a high rate of intimal hyperplasia formation and stenosis with Cormatrix implantation in the low-pressure small-diameter vasculature. [32] Our in vitro study indicates that Cormatrix has supportive properties and biocompatibility with both human and swine MSCs.
Use of Cormatrix for Semilunar Valve Repair in Children: Variations on a Theme
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Meeting Presentation: Presented at the 95th Annual Meeting of the American Association for Thoracic Surgery, Seattle, Washington, 25–29 April, 2015.