Encouraging Experience with Intracardiac Transplantation of Unselected Autologous Bone Marrow Cells Concomitant with Coronary Artery Bypass Surgery after Myocardial Infarction

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概要

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• Background: Chronic heart failure after myocardial infarction is still a serious problem without a fundamental therapy. Experimental transplantation of bone marrow cells (BMC) into infarcted myocardium resulted in regeneration and functional improvement.Objective: Clinical investigation of safety and efficacy of intracardiac transplantation of unselected autologous BMC. Method: 22 patients scheduled for elective and isolated coronary artery bypass grafting (CABG) with a reduced LVEF due to myocardial infarction were included. Intraoperatively, sternal bone marrow blood was aspirated, and a sterile buffy coat was prepared and applicated. 19 age, LVEF and coronary disease matched patients served as controls. Heart function, geometry, and scar proportion were assessed by echocardiography and Gadolinium-MRI at the time of the operation and 6 months thereafter.Results: Transplanted patients received a mean number of 360 × 106 BMC. We did not notice any significant differences in early or late complications in the transplant group as compared to controls. At six months follow up only the transplanted patients showed a significant improvement of NYHA classes from 2.7 to 1.5 and of LVEF from 36 to 43 %, (p < 0.05). Furthermore, only CABG concomitant with BMC-TX led to a significant reduction of left ventricular end diastolic diameter (LVEDD) from 59 to 54 mm and of scar proportion of the infarcted segments from 2.53 to 2.42, (p < 0.05).Conclusion: Intracardiac transplantation of unselected, autologous BMC is safe and feasible. In adjunct with coronary revascularization it leads to an improvement of ventricular geometry and function. Moreover, it reduces myocardial scar proportion and heart failure symptoms.

• 2011-08-01

著者

• Konertz Wolfgang

  Department Of Cardiovascular Surgery Charite Hospital Medical University Berlin

• HOLINSKI Sebastian

  Department of Cardiovascular Surgery, Charite Hospital, Medical University

• Holinski Sebastian

  Department Of Cardiovascular Surgery Charite Hospital Medical University

• Claus Benjamin

  Department Of Cardiovascular Surgery Charite Hospital Medical University

• Elgeti Thomas

  Department Of Radiology Charite Humboldt University

• Radtke Hartmut

  Institute Of Transfusion Medicine Charite Humboldt University

• SCHMECK Birte

  Department of Cardiovascular Surgery, Charite, Humboldt University

• HOLZHAUSEN Martin

  Department of Biometry, Charite, Humboldt University

• Schmeck Birte

  Department Of Cardiovascular Surgery Charite Humboldt University

• Holzhausen Martin

  Department Of Biometry Charite Humboldt University

• Konertz Wolfgang

  Department Of Cardiovascular Surgery Charite Hospital Medical University

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