Tissue Reaction to Porcine Intestinal Submucosa (CorMatrix) Implants in Pediatric Cardiac Patients: A Single-Center Experience Frances Rosario-Quinones,

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Tissue Reaction to Porcine Intestinal Submucosa (CorMatrix) Implants in Pediatric Cardiac Patients: A Single-Center Experience Frances Rosario-Quinones, MD, Margret S. Magid, MD, Jen Yau, RDCS, Amit Pawale, MD, Khanh Nguyen, MD The Annals of Thoracic Surgery Volume 99, Issue 4, Pages 1373-1377 (April 2015) DOI: 10.1016/j.athoracsur.2014.11.064 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) A low-power (original magnification ×40) photomicrograph shows the excised pulmonary artery graft. Acellular darkly eosinophilic CorMatrix material (CorMatrix, Atlanta, GA) is on the right (arrow), underlain by inflammatory infiltrates and fibrosis (hematoxylin and eosin stain). (B) A medium-power (original magnification ×100) photomicrograph shows the band-like infiltrate below the CorMatrix material (arrow). Inset: The inflammatory infiltrate consists of eosinophils, plasma cells, and histiocytes (original magnification ×400; hematoxylin and eosin stain). The Annals of Thoracic Surgery 2015 99, 1373-1377DOI: (10.1016/j.athoracsur.2014.11.064) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Trichrome stain of the excised CorMatrix (CorMatrix, Atlanta, GA) pericardial patch. The glassy blue CorMatrix material is on the surface to the right (arrow). Reactive fibrosis, staining densely blue, is present in the native tissues below, surrounding the mixed inflammatory-eosinophilic infiltrates (poorly seen on trichrome stain; original magnification ×40). The Annals of Thoracic Surgery 2015 99, 1373-1377DOI: (10.1016/j.athoracsur.2014.11.064) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Pulmonary arteriogram shows stenosis of a previously patched left branch pulmonary artery. The Annals of Thoracic Surgery 2015 99, 1373-1377DOI: (10.1016/j.athoracsur.2014.11.064) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Aortogram reveals severe narrowing of the distal aortic arch at the site of the CorMatrix patch (CorMatrix, Atlanta, GA). The Annals of Thoracic Surgery 2015 99, 1373-1377DOI: (10.1016/j.athoracsur.2014.11.064) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions