Konertz_4386 r1.qxd:Layout 1

The surgical repair of complex congenital heart disease often requires reconstruction of the right ventricular outflow tract (RVOT) with a valve-bearing conduit. Although, currently, allografts and xenografts are in clinical use, both have significant disadvantages. Notably, allografts are in short supply (especially in small sizes) and they deteriorate quite rapidly (1), whereas xenografts either become stenotic (2) or tend to dilate (3). One advantage of xenografts, however, is their instant availability. Tissue engineering technology with decellularized allografts (4) and xenografts (5) has led to effective early results in adults following pulmonary valve replacement during the Ross operation. The decellularization process leads to a soft and pliable tissue, permits a good hemodynamic performance, has a potential for valve remodeling and growth, and also reduces calcification (6). The Matrix P® is a decellularized porcine pulmonary valve which is produced by AutoTissue GmbH, Berlin, Germany, following patented decellularization and sterilization protocols (7). In order to facilitate implantation especially in cases where distal or proximal patch extensions are required the Matrix P Plus® a Matrix P valve with an equine pericardial patch extension has been developed. Both valves are available in 2 mm increments from 11 to 27 mm, have been recognized as effective by receipt of the CE mark since 2004 (Matrix P) and 2005 (Matrix P Plus), and are freely available in Europe. The study aim was to report the shortand mid-term performance of these decellularized porcine xenografts in children and patients with congenital Address for correspondence: Wolfgang Konertz MD, PhD, Department of Cardiovascular Surgery, Charité Berlin, Charitéplatz 1, 10117 Berlin, Germany e-mail: [email protected]