Novel Use of Extracellular Matrix Graft for Creation of Pulmonary Valved Conduit

Abstract

We report the use of a commercially available graft material to create a trileaflet pulmonary valved conduit, which was implanted in a 12-year-old girl with mixed aortic valve disease as part of a Ross procedure. The patient presented with severe aortic insufficiency and left ventricular dilatation following balloon valvuloplasty. The patient lives in Ecuador, where most commonly used replacements for the pulmonary valve are either unavailable or unaffordable. Our technique involves the use of porcine small intestinal submucosal extracellular matrix (SIS-ECM), commercially available as CorMatrix ECM (CorMatrix Cardiovascular, Inc, Tallahassee, Florida) to create a trileaflet-valved conduit.

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

“…This is particularly exciting because there is evidence for resorption of the SIS-ECM, replacement with organized collagen, and reendothelialization in tissues that have been explanted from cardiac patients [7]. Other reports have demonstrated the early success of creating handmade valved conduits on the pulmonary side with the use of similar material [8], but as with our case, these reports have very short-term follow-up. Extracellular matrix applications require an M2 phenotype macrophage mediated inflammatory cell ingrowth with thickening of the material, which then leads to stem cell migration and tissue proliferation to match the function needed for the environment.…”

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.…”

Echocardiographic Analysis of an Extracellular Matrix Tricuspid Valve

“…Using ECM material to create valves is a relatively new technique with potential benefits not available from mechanical or other bioprosthetic valves . Minimal data exist as to the mechanism(s) of how these cylinder‐type valves function in vivo.…”

“…Using ECM material to create valves is a relatively new technique with potential benefits not available from mechanical or other bioprosthetic valves. [1][2][3][4] Minimal data exist as to the mechanism(s) of how these cylinder-type valves function in vivo. In this case, 2DTEE images showed tricuspid valve regurgitation, but the mechanism of regurgitation was not clearly defined.…”