title: Tissue reaction to porcine intestinal Submucosa (CorMatrix) implants in pediatric cardiac patients: a single-center experience.
abstract: BACKGROUND
  Decellularized porcine small intestine submucosa (CorMatrix, Atlanta, GA) patches have been used in the repair of congenital heart malformations. Tissue reaction to the material may create hemodynamic dysfunction and necessitate explantation. We reviewed our series of congenital cardiac patients who had a reoperation after the implantation of CorMatrix patches.
  
  
  METHODS
  Medical records of pediatric cardiac patient who received CorMatrix patches and those of patients who underwent reoperation were reviewed. Routine histologic sections of explanted CorMatrix specimens were examined.
  
  
  RESULTS
  Of 25 patients who had received CorMatrix patches during cardiac operations at our institution, 6 patients had undergone reoperations. All patients had hemodynamically significant lesions at the site of the CorMatrix implantation. Explanted specimens were associated with an intense inflammatory reaction consisting of numerous eosinophils, histiocytes, and plasma cells, with accompanying granulation tissue and fibrosis.
  
  
  CONCLUSIONS
  Reaction to implanted CorMatrix patches may cause hemodynamic dysfunction and produce an intense, predominantly eosinophilic inflammatory response with developing fibrosis. Although our report is limited to a small sample of congenital cardiac patients, one should take precautions in its use in pediatric cardiac patients, and long-term follow-up is warranted.
authors.affiliation: Department of Pathology, Mount Sinai Hospital, New York, New York.
authors.forename: Frances
authors.initials: F
authors.lastname: Rosario-Quinones
authors.affiliation: Department of Pathology, Mount Sinai Hospital, New York, New York.
authors.forename: Margret S
authors.initials: MS
authors.lastname: Magid
authors.affiliation: Division of Pediatric Cardiology, Mount Sinai Hospital, New York, New York.
authors.forename: Jen
authors.initials: J
authors.lastname: Yau
authors.affiliation: Department of Cardiovascular Surgery, Mount Sinai Hospital, New York, New York.
authors.forename: Amit
authors.initials: A
authors.lastname: Pawale
authors.affiliation: Department of Cardiovascular Surgery, Mount Sinai Hospital, New York, New York. Electronic address: khanh.nguyen@mountsinai.org.
authors.forename: Khanh
authors.initials: K
authors.lastname: Nguyen
mesh_terms: D000818:Animals; D001705:Bioprosthesis; D001707:Biopsy, Needle; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D007413:Intestinal Mucosa / Q000601:surgery / Q000637:transplantation*; D008297:Male; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013552:Swine; D016896:Treatment Outcome