Contrasting the Performance of a Surgeon-Fashioned Extracellular Matrix Cylindrical Tricuspid Valve Versus a Mechanical Valve

We present a patient who as an infant required mitral and tricuspid valve replacement, with a mechanical valve used in the mitral position and a surgeon fashioned extracellular matrix of porcine small intestinal submucosa (SIS-ECM) (CorMatrix) valve in the tricuspid position. Five years later, the mechanical valve required replacement with a larger mechanical valve. Although the CorMatrix tricuspid valve did not show significant signs of thrombosis or calcification, it was also replaced with a mechanical valve. That mechanical valve thrombosed twice within one year and both times required surgery for replacement. After the second thrombotic event, however, a new hand sutured SIS-ECM valve was used in place of a mechanical valve. The new SIS-ECM tricuspid valve continues to function appropriately 17 months later, and the patient has remained asymptomatic.