Preliminary experience with porcine intestinal submucosa (CorMatrix) for valve reconstruction in congenital heart disease: Histologic evaluation of explanted.

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Preliminary experience with porcine intestinal submucosa (CorMatrix) for valve reconstruction in congenital heart disease: Histologic evaluation of explanted valves Abbas Haider Zaidi, MD, Meena Nathan, MD, Sitaram Emani, MD, Christopher Baird, MD, Pedro J. del Nido, MD, Kimberlee Gauvreau, ScD, Marian Harris, MD, PhD, Stephen P. Sanders, MD, Robert F. Padera, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 148, Issue 5, Pages 2216-2225.e1 (November 2014) DOI: 10.1016/j.jtcvs.2014.02.081 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Medium power photomicrographs of CorMatrix material at 18 days (patient 3) showing the layered connective tissue matrix, which was eosinophilic on hematoxylin and eosin staining. The nuclei seen on the bottom of the hematoxylin and eosin image were host inflammatory cells rather than cells indigenous to the CorMatrix. Original magnification ×100. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2216-2225.e1DOI: (10.1016/j.jtcvs.2014.02.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Low power photomicrograph of the inflammatory response to the CorMatrix material at 114 days (patient 7). Hematoxylin and eosin stain, original magnification ×40. B, Medium power photomicrograph of the inflammatory response to the CorMatrix material at 198 days (patient 8). A mixed infiltrate of lymphocytes, macrophages, plasma cells, and eosinophils were present. Hematoxylin and eosin stain, original magnification ×100. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2216-2225.e1DOI: (10.1016/j.jtcvs.2014.02.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 High power photomicrographs of the eosinophilic infiltrate around the CorMatrix material at (A) 27 days (patient 2) and (B) 198 days (patient 8). Hematoxylin and eosin stain, original magnification ×200. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2216-2225.e1DOI: (10.1016/j.jtcvs.2014.02.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Medium power photomicrograph of the neointimal (NI) layer consisting of fibrous tissue with mild chronic inflammation and occasional blood vessels around the CorMatrix (CM) material at 223 days (patient 6). Also, note the macrophages and foreign body giant cells at the material–tissue interface. Hematoxylin and eosin stain, original magnification ×100. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2216-2225.e1DOI: (10.1016/j.jtcvs.2014.02.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 A, Medium power photomicrograph of palisading histiocytes at the border between the CorMatrix (CM) material and host tissue at 63 days (patient 10), with a moderate chronic inflammatory response in the surrounding host tissue. Hematoxylin and eosin stain, original magnification ×100. B, High power photomicrograph of macrophages and foreign body giant cells at the CorMatrix (CM)–tissue interface. Hematoxylin and eosin stain, original magnification ×200. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2216-2225.e1DOI: (10.1016/j.jtcvs.2014.02.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 A and B, Low power photomicrographs of the host tissue response to autologous pericardium (AP) showing neointimal (NI) formation, with an absence of inflammation in the surrounding host tissue at 940 days (patients 1). A, Hematoxylin and eosin stain and B, trichome stain; original magnification ×40 for both. C, Medium power photomicrograph showing an absence of inflammation adjacent to autologous pericardium (AP) at 163 days (patient 5). Hematoxylin and eosin stain, original magnification ×100. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2216-2225.e1DOI: (10.1016/j.jtcvs.2014.02.081) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions