Author + information
- S1936879815022001-d3a5f3a61415c86c829c489cc39def51Zahra Mosala Nezhad1,
- S1936879815022001-bd994903a5166d4932b4d50940f81ec3Alain Poncelet1,
- S1936879815022001-ac52dbb35b6458b2b6321368da0b367cLaurent de Kerchove1,
- S1936879815022001-87de66d14a5dbc7b9f71465775beca8cCaroline Fervaille2,
- S1936879815022001-db83f9edada7d06b248c54c10915399aXavier Boullin3,
- S1936879815022001-5db582d0229a05f6cdddbca4b23712c9Jean-Paul Dehoux4,
- S1936879815022001-e05370a28f9cbf10019274e2d0707a58Gebrine Elkhoury1 and
- S1936879815022001-b76b195603cfd44b320ecbf7a9709239Pierre Gianello5
- 1Universite Catholique de Louvain UCL-Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular research (CARD), Saint-Luc University hospital, Department of cardiovascular and thoracic surgery, Brussels, Belgium
- 2Universite Catholique de Louvain UCL-Godinne University Hospital-CHU, Laboratory of Anatomy Pathology, Godinne, Belgium
- 3Universite Catholique de Louvain UCL-Institute of Mechanics, Materials and Civil Engineering, Center for Research in Energy and Mechatronics, Brussels, Belgium
- 4Universite Catholique de Louvain UCL-Health Sciences sector, Faculty of Medicine and Dentistry, Animals housing facility, Brussels, Belgium
- 5Universite Catholique de Louvain UCL-Institute of Experimental and Clinical Research (IREC), Division of Experimental surgery and transplantation (CHEX), Brussels, Belgium
Porcine small intestinal submucosa extracellular matrix, CorMatrix (CorMatrix Cardiovascular, Roswell, GA) is potentially suitable tissue substitute for cardiovascular use. We investigate the biological reaction and remodeling of CorMatrix, as a tri-leaflet valve conduit in growing pig model. We hypothesized that CorMatrix would maintain a durable architecture as a valve conduit and that it would remodel to resemble the surrounding tissues.
Using 7x10cm 4ply sheet, we made the conduit, and placed it in the pig’s thoracic aorta using an arterial shunt. Testing periods were 3, 4, 5, and 6 months respectively. We examined the explants for biodegradation, degree of replacement by native tissue, and durability by histology, immunohistochemistry and mechanical testing.
Four pigs, one per time frame, concluded the study. The conduit lost its original architecture as a tri-leaflet valve and evolved as an arterial wall with the valve segment being thicker. The scaffold’s resorption didn’t follow a timely process and was incomplete with disorganized degradation even at 6 months. Chronic inflammation persisted, and fibrosis, scaring and early calcifications started at 4 months. The partially remodeled scaffold did not resemble the aortic wall. This suggests impaired remodeling. Mechanical testing showed weaker properties of the tissues over time which was liable to breakage.
CorMatrix is biodegradable and potentially can remodel. The remodeling process is multifactorial, dependent on the patch, host response and anatomical location. As a valve conduit in an arterial environment; the growth was neither structured nor anatomical. Failure of remodeling explained by the complexity of the conduit structure, and the host’s chronic inflammatory response leading to early fibrosis and calcification.