Clinical experience with CorMatrix extracellular matrix in the surgical treatment of mitral valve disease

ObjectivesTo determine the clinical utility of an acellular bioscaffold as a structural material for mitral valve repair (MVr).MethodsThis was a retrospective study of patients undergoing partial or subtotal leaflet replacement and/or leaflet extension to treat mitral regurgitation or acute endocarditis and/or reconstruction of atrial–ventricular continuity after annular decalcification. The material used for repair was a bioresorbable extracellular matrix (ECM) material indicated for cardiac tissue repair (CorMatrix Cardiovascular, Inc, Roswell, Ga). After the necessary debridement, the ECM bioscaffold was tailored and sewn to the native mitral valve tissue. Intraoperative photographs and serial, follow-up echocardiograms were used for evaluation.ResultsFrom September 2008 to February 2013, MVr requiring the addition of patch material was performed in 19 patients. The median echocardiographic follow-up was 10.9 months (range, 4 days to 48 months). One early and 2 late deaths were unrelated to MVr. No perioperative or late strokes occurred. Two patients with a history of cancer, chemotherapy, and radiotherapy experienced failure of the initial MVr, necessitating reintervention. The other MVrs continued to show good valvular function and no calcification on echocardiographic follow-up of 4 days to 48 months.ConclusionsThe ECM bioscaffold is a satisfactory material for MVr in a variety of surgical situations, including endocarditis. It appears to resist calcification and infection. Additional studies are warranted to determine the long-term durability of repairs made with ECM, and its appropriate use in patients who have previously undergone radiotherapy or chemotherapy.