Author + information
- Zahra Mosala Nezhad1,
- Alain Poncelet1,
- Laurent de Kerchove1,
- Caroline Fervaille2,
- Xavier Boullin3,
- Jean-Paul Dehoux4,
- Gebrine Elkhoury1 and
- Pierre 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.