Are Extracellular Matrix ‘Patches’ the Future for Pediatric Cardiac Tissue Repair?

Research By David Morales, MD

Post Date: November 13, 2019 | Publish Date: Sept./Oct. 2019

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Image of the ECM patch inserted into the right ventricle of ovine model.

Patching a heart to repair cardiac irregularities is a common and proven therapy for infants with congenital heart defects. However, no material for creating such patches has been considered ideal.

Now a team of experts from the Heart Institute at Cincinnati Children’s reports results from testing the robustness of an acellular extracellular matrix (ECM) patch in young large mammals. This type of patch is thought to aid in the communication of nearby cells to re-cellularize and re-vascularize the injured heart. The study was led by first author Scott Baker, senior research associate, and senior author David Morales, MD, Director of Congenital Heart Surgery at the Heart Institute.

Electrical, mechanical and histological properties of the ECM patch, used to repair a right ventricular wall defect, were assessed over 12 months. The team observed consistent conduction across the patch for a year, with strain properties (as assessed by MRI imaging) similar to natural tissue. No patch failures occurred.

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After 12 months of monitoring, voltage measurements remained similar between the patch and native myocardium.

Such observations suggest that the patch is functional and durable. However, unlike previous studies using this patch to repair other cardiac tissues, new heart muscle cells did not populate the patched area in significant numbers.

Further studies are needed to determine the longer-term durability of ECM patches and whether this material can create an environment for tissue remodeling.

In other studies, the research team detected remodeling characteristics when this material was used to replace a tricuspid valve. That work has led to a clinical trial, underway now, to evaluate ECM material for tricuspid valve replacement in adults and children.

—This post was authored by Emma Agnew, PhD, Research Fellow, Heart Institute at Cincinnati Children’s. Find Dr. Agnew on Instagram (@emmascience) and Twitter (@DrEJAgnew).

Publication Information

Original Title:In Vivo Remodeling of an Extracellular Matrix Cardiac Patch in an Ovine Model
Published in:ASAIO Journal
Publish date:Sept./Oct. 2019

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Research By

  • David Morales, MD

    David Morales, MD

    Director, Congenital Heart Surgery, Heart Institute

    Dr. Morales conducts clinical and translational research related to mechanical circulatory support and tissue engineering.