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Biomaterial utilizes body’s innate ability to heal damaged CV tissue
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New data suggest that patients undergoing pericardial reconstruction with extracellular matrix, a biomaterial that attracts the body’s own stem cells and biodegrades in 3 months, had a statistically significant reduction in the rate of new onset postoperative atrial fibrillation.
The extracellular matrix (ECM, CorMatrix Cardiovascular Inc.) technology is derived from porcine small intestine submucosa, a complex matrix of collagen that supplies strength to the intestine, while serving as a reservoir for cytokines that support the growth and differentiation of intestinal epithelial cells. In the heart, the biomaterial serves as a scaffold for constructive remodeling of native tissue structures and supports early and abundant new vessel growth, according to a press release. The material is then gradually replaced as the patient’s own body reinforces and rebuilds the weakened site.
Since its approval in May 2008, the ECM material has been used more than 25,000 times to repair damaged hearts.
“I do a lot of reconstructive surgery in the heart, and I’ve started to use CorMatrix’s ECM as my material of choice,” Allan Stewart, MD, director of aortic surgery, Columbia University Medical Center, New York, said in an interview. “In the past, we were limited to use either the patient’s own pericardium or a bovine pericardium for reconstruction. The problem with that is that both of these materials calcify. CorMatrix, at least in the short term, seems to function like native tissue, especially when used for valve reconstruction.”
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Photo courtesy of: CorMatrix |
“This is probably one of the most exciting technologies I have been involved with in my entire career,” Douglas Boyd, MD, professor of surgery and director of robotics and biosurgery at the UC Davis Medical Center in California, told Cardiology Today. “The ECM technology is changing the paradigm of medicine and surgery and how we think about surgery. We as surgeons used to think how are we going to repair [injured heart muscle], can we repair it or will we need to replace it? But now the new question surgeons are going to have to ask themselves is, ‘Can we regenerate this patient’s injured or damaged tissues?’”
Data from a newly published retrospective trial has helped elucidate the benefits of this regenerative technology in patients with AF. According to a press release, ECM led to a 54% reduction in RR of postoperative AF in patients undergoing primary isolated CABG (P<.001).
“A reduction in AF would be an enormous advantage because roughly 40% of patients get postoperative AF, which delays their discharge and sometimes necessitates them being on Coumadin (warfarin, Bristol-Myers Squibb) for at least a period of time,” Stewart said. “So if we can prevent that or at least lessen the incidence of AF, [ECM] would be an enormously effective device.”
Recently, CorMatrix was awarded $2.3 million in grants under the US government’s Qualifying Therapeutic Discovery Project (QTDP) program to advance the research and development of the ECM technology.
“What we are going to see in the upcoming years is a much greater understanding of the critical importance of matrix in cell biology, not just in cardiology but in a number of other fields as well,” Boyd said. – by Brian Ellis
Boyd W. Heart Surg Forum. 2010;13:E311-316.
Editor’s Note:
- Dr. Boyd serves on the scientific advisory board of CorMatrix. Dr. Stewart reports no relevant conflicts of interest.