Yanagawa Bobby, Rao Vivek, Yau Terrence M, Cusimano Robert J
From the Division of Cardiovascular Surgery, University Health Network, Department of Surgery, University of Toronto, Toronto, ON Canada.
Innovations (Phila). 2013 Sep-Oct;8(5):348-52. doi: 10.1097/IMI.0000000000000014.
Pericardial patches for intraventricular repair are limited by progressive calcification, thickening, and retraction. The aim of this study was to evaluate the safety of CorMatrix extracellular matrix (ECM) for intraventricular repair of mechanical complications of myocardial infarction (MI).
CorMatrix ECM is a novel material synthesized from decellularized porcine small intestinal submucosa. Between July 2011 and October 2012, a total of 11 consecutive patients with post-MI complications including ventricular aneurysm (n = 7), ventricular septal defect (VSD; n = 3), and both aneurysm and VSD (n = 1) underwent patch repair using CorMatrix ECM. Clinical follow-up and interval transthoracic echocardiography data were collected.
Eleven patients underwent Dor or linear left ventricular aneurysm repair and/or patch VSD repair. There were two reoperations and one surgical mortality but no cases of CorMatrix ECM repair failures. The mean ± SD clinical follow-up was 207 ± 211 days, and the longest follow-up was 642 days, during which there was no readmission for any cardiac cause or death. The mean ± SD transthoracic echocardiography follow-up was 176 ± 220 days, which demonstrated integrity of CorMatrix ECM repair in all cases.
In our series, CorMatrix ECM was a safe alternative for ventricular patch repair of mechanical complications after MI in the short-term. This series supports the continued study of the efficacy and the regenerative potential of this novel material for cardiac repair.
用于心室内修复的心包补片存在进行性钙化、增厚和回缩的局限性。本研究旨在评估CorMatrix细胞外基质(ECM)用于心肌梗死(MI)机械并发症的心室内修复的安全性。
CorMatrix ECM是一种由去细胞猪小肠黏膜下层合成的新型材料。在2011年7月至2012年10月期间,共有11例连续的MI后并发症患者,包括室壁瘤(n = 7)、室间隔缺损(VSD;n = 3)以及同时存在室壁瘤和VSD(n = 1),接受了使用CorMatrix ECM的补片修复。收集了临床随访和间隔期经胸超声心动图数据。
11例患者接受了Dor手术或线性左心室室壁瘤修复和/或补片VSD修复。有2例再次手术和1例手术死亡,但没有CorMatrix ECM修复失败的病例。临床随访的平均±标准差为207±211天,最长随访时间为642天,在此期间没有因任何心脏原因再次入院或死亡。经胸超声心动图随访的平均±标准差为176±220天,所有病例均显示CorMatrix ECM修复完整。
在我们的系列研究中,CorMatrix ECM在短期内是MI后机械并发症心室补片修复的一种安全替代方法。该系列研究支持继续研究这种新型材料用于心脏修复的疗效和再生潜力。