Feasibility and Early Effectiveness of a Custom, Hand-Made Systemic Atrioventricular Valve Using Porcine Extracellular Matrix (CorMatrix) in a 4-Month-Old Infant

Custom extracellular matrix cylinder mitral valve in a pediatric patient

“…[1][2][3][4][5][6][7][8] This commercial formulation is a 2-layer dry sheet of ECM that is harvested from porcine intestinal submucosa and subsequently decellularized. [1][2][3][4][5][6][7][8] This commercial formulation is a 2-layer dry sheet of ECM that is harvested from porcine intestinal submucosa and subsequently decellularized.…”

“…2,6,7 Cylinder valve prolapse seems to be well tolerated without regurgitation and may allow for left ventricular (LV) long-axis somatic growth without potential restriction/tethering of leaflet mobility over the mid-to longer-term follow-ups. The ECM in other applications has noted to thicken in the first 3-6 months after implantation as cellularization and replacement of the material ensues.…”

“…Constructing ECM valves is a relatively new technique with potential benefits not available from mechanical or other bioprosthetic valves for infants and small pediatric patients. [1][2][3][4][5][6][7][8] This commercial formulation is a 2-layer dry sheet of ECM that is harvested from porcine intestinal submucosa and subsequently decellularized. Animal studies of cylinder valves demonstrate that the matrix is replaced with autologous tissues over 6-9 months.…”

“…The ECM in other applications has noted to thicken in the first 3-6 months after implantation as cellularization and replacement of the material ensues. 2,6,7 Cylinder valve prolapse seems to be well tolerated without regurgitation and may allow for left ventricular (LV) long-axis somatic growth without potential restriction/tethering of leaflet mobility over the mid-to longer-term follow-ups. Furthermore, by better maintaining LV and papillary muscle mechanics, as a cylinder valve reconstitutes annulo-papillary continuity, it is likely that LV ejection fraction may be better maintained as has been demonstrated after mitral replacement in adults with chordal preservation techniques.…”

Porcine small intestine submucosa cylinder valve for mitral and tricuspid valve replacement

“…1 Handmade CorMatrix cylinder valves (CorMatrix, Roswell, Ga; porcine small intestinal submucosa) in the tricuspid and mitral positions have been reported in small series of children. [2][3][4] The cylinder valve has been used in 19 adult patients with tricuspid valve (TV) endocarditis 5 and is undergoing a clinical trial of a factory-produced CorMatrix cylinder valve for adult TV replacement. We report 2 pediatric patients in whom CorMatrix cylinder valves were implanted.…”