ECM-derived medical implants

The history of extracellular matrix (ECM)-derived medical implants is one of innovation and reinvention that spans over seven decades of cardiovascular surgery. The applications of ECM-deiived implants in these fields are broad replacement of cardiac valves, reconstruction of arteries and veins, creation of hemodialysis access, extending the lifespan of vascular reconstructions, and repairing trauma. Although there are currently a large number of ECM-derived prosthetics available for human use, understanding their similarities and differences, as well as their overall position in the general arena of implantable devices, will allow continued evolution and new applications for these versatile ECM-derived materials. 

With regard to cardiovascular surgery, although ECM-derived medical implants can be constructed from a variety of materials, there are several desirable properties in common to these materials when used in the vascular system. The final implantable object should have a low risk of restenosis and calcification. The material should be resistant to infection, antithrombogenic, stable, durable, and easy to obtain, handle, and prepare. Ideally, the ECM-based biomaterial should have a compliance comparable to host vessels. ... 

Pericardium has also been used as a heart valve, revolutionizing the field of cardiothoracic surgery. In 1965 Duran and Gunning published their work on successful implantation of a porcine aortic valve into a dog and a human aortic valve was replaced by a porcine bioprosthesis shortly afterward. Soon this ECM-derived medical implant became standardized and conunercially available, and bovine pericardium was also developed for patient use as an alternative to the porcine valve. 

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