Pathological Changes of Adult Mitral Valves after Failed CorMatrix ECM Repair

doi:10.14218/jctp.2021.00009

Cited by 1 publication

(2 citation statements)

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“…While in preclinical studies, SIS-ECM has shown very encouraging results ( Badylak et al, 1989 ; Lantz et al, 1992 ; Fallon, 2011; Padalino et al, 2012 ; Baker, 2018), the application of CorMatrix® in the clinic has not produced the same results. Immune reactions, inflammatory processes with the thickening of the patch, and finally calcifications in the surrounding tissue, were present in almost all cases considered (Woo, 2015; Nelson et al, 2016 ; Chakraborty 2021 ; Sood et al, 2021 ). To achieve our goal, we compared two decellularization protocols: the first based on the use of Triton X 100, as a non-ionic detergent and the second with its substitute, Tergitol 15 S 9.…”

Section: Discussionmentioning

confidence: 94%

“…Immune reactions, inflammatory processes with the thickening of the patch, and finally calcifications in the surrounding tissue, were present in almost all cases considered (Woo, 2015;Nelson et al, 2016;Chakraborty 2021;Sood et al, 2021). To achieve our goal, we compared two decellularization protocols: the first based on the use of Triton X 100, as a non-ionic detergent and the second with its substitute, Tergitol 15 S 9.…”

Section: Discussionmentioning

confidence: 99%

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Small intestinal submucosa-derived extracellular matrix as a heterotopic scaffold for cardiovascular applications

Palmosi

Tolomeo

Cirillo

et al. 2022

Front. Bioeng. Biotechnol.

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Structural cardiac lesions are often surgically repaired using prosthetic patches, which can be biological or synthetic. In the current clinical scenario, biological patches derived from the decellularization of a xenogeneic scaffold are gaining more interest as they maintain the natural architecture of the extracellular matrix (ECM) after the removal of the native cells and remnants. Once implanted in the host, these patches can induce tissue regeneration and repair, encouraging angiogenesis, migration, proliferation, and host cell differentiation. Lastly, decellularized xenogeneic patches undergo cell repopulation, thus reducing host immuno-mediated response against the graft and preventing device failure. Porcine small intestinal submucosa (pSIS) showed such properties in alternative clinical scenarios. Specifically, the US FDA approved its use in humans for urogenital procedures such as hernia repair, cystoplasties, ureteral reconstructions, stress incontinence, Peyronie’s disease, penile chordee, and even urethral reconstruction for hypospadias and strictures. In addition, it has also been successfully used for skeletal muscle tissue reconstruction in young patients. However, for cardiovascular applications, the results are controversial. In this study, we aimed to validate our decellularization protocol for SIS, which is based on the use of Tergitol 15 S 9, by comparing it to our previous and efficient method (Triton X 100), which is not more available in the market. For both treatments, we evaluated the preservation of the ECM ultrastructure, biomechanical features, biocompatibility, and final bioinductive capabilities. The overall analysis shows that the SIS tissue is macroscopically distinguishable into two regions, one smooth and one wrinkle, equivalent to the ultrastructure and biochemical and proteomic profile. Furthermore, Tergitol 15 S 9 treatment does not modify tissue biomechanics, resulting in comparable to the native one and confirming the superior preservation of the collagen fibers. In summary, the present study showed that the SIS decellularized with Tergitol 15 S 9 guarantees higher performances, compared to the Triton X 100 method, in all the explored fields and for both SIS regions: smooth and wrinkle.

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