Single-Center Experience with the Matrix Patch and Its Application in Congenital Heart Surgery

Objectives: Autologous pericardium is the material of choice for many repairs. The search for alternative patch materials without calcification or shrinkage is ongoing. We report our early experience with the decellularized equine pericardial Matrix Patch.

Methods: A retrospective data analysis was performed for 132 implanted patches from September 2016 to July 2018. The patch was used in 121 patients (52% male and 48% female) with a mean age of 5.21 ± 7.91 years at the time of implantation. The patch was used according to manufacturer recommendation. However, for use in high pressure areas, additional fixation with glutaraldehyde was used to prevent patch dilation. Mean follow-up time is 9.9 ± 6.9 months.

Results: The patch was primarily used in redo surgery (78.5%) and implanted in 202 locations. The main use was enlargement of the pulmonary arteries and the right ventricular outflow tract (55.9%). Other common applications were reconstruction of the interatrial or interventricular septum (16.3%) including PAPVD repair and augmentation of the aortic root, ascending aorta, or aortic arch (9.9%). In 14 patients, the patch was implanted to the heart valves with mitral valve leaflet augmentation in six, aortic cusp augmentation in three, pulmonary monocusp construction in four, and fenestrated closure of the tricuspid valve during Starnes procedure in one.

There were no graft-related deaths. Unplanned reinterventions to the pulmonary arteries were necessary in 12.4% for recurrent stenosis but also residual lesions. Three out of six patients underwent mitral valve replacement. In one patient, aortic valve repair was nonsuccessful and a Ross procedure was performed during the same surgery.

Conclusion: The Matrix Patch is suitable for implantation in a variety of congenital heart lesions especially if autologous pericardium is not available. However, long-term follow-up data are still lacking to proof its durability.