title: Small intestinal submucosa extracellular matrix (CorMatrix®) in cardiovascular surgery: a systematic review.
abstract: Extracellular matrix (ECM) derived from small intestinal submucosa (SIS) is widely used in clinical applications as a scaffold for tissue repair. Recently, CorMatrix® porcine SIS-ECM (CorMatrix Cardiovascular, Inc., Roswell, GA, USA) has gained popularity for 'next-generation' cardiovascular tissue engineering due to its ease of use, remodelling properties, lack of immunogenicity, absorbability and potential to promote native tissue growth. Here, we provide an overview of the biology of porcine SIS-ECM and systematically review the preclinical and clinical literature on its use in cardiovascular surgery. CorMatrix® has been used in a variety of cardiovascular surgical applications, and since it is the most widely used SIS-ECM, this material is the focus of this review. Since CorMatrix® is a relatively new product for cardiovascular surgery, some clinical and preclinical studies published lack systematic reporting of functional and pathological findings in sufficient numbers of subjects. There are also emerging reports to suggest that, contrary to expectations, an undesirable inflammatory response may occur in CorMatrix® implants in humans and longer-term outcomes at particular sites, such as the heart valves, may be suboptimal. Large-scale clinical studies are needed driven by robust protocols that aim to quantify the pathological process of tissue repair.
authors.affiliation: Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium zahra.mosalanezhad@gmail.com.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Mosala Nezhad
authors.affiliation: Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium.
authors.forename: Alain
authors.initials: A
authors.lastname: Poncelet
authors.affiliation: Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: de Kerchove
authors.affiliation: Institute of Experimental and Clinical Research (IREC), Division of Experimental Surgery and Transplantation (CHEX), Université catholique de Louvain, Brussels, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Gianello
authors.affiliation: Laboratory of Anatomy Pathology, Université catholique de Louvain, Godinne University Hospital-CHU, Yvoir, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Fervaille
authors.affiliation: Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium.
authors.forename: Gebrine
authors.initials: G
authors.lastname: El Khoury
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000601:surgery*; D005109:Extracellular Matrix / Q000637:transplantation*; D006801:Humans; D007421:Intestine, Small / Q000166:cytology* / Q000637:transplantation; D019736:Prostheses and Implants; D011474:Prosthesis Design; D023822:Tissue Engineering / Q000379:methods*
keywords: Cardiovascular surgery; CorMatrix; Extracellular matrix; Small intestinal submucosa; Tissue engineering