2012, Number 2
Non-Manipulated Autologous Bone Marrow-Derived Mononuclear Cells Implant in Cases of Resistant Chronic Heart Failure
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ABSTRACTBackground: Transcoronary unselected autologous bone marrow mononculear cells (ABMMC) implant through coronary arteries or veins had shown clinical benefit in patients with acute and chronic heart diseases. Different procedures had been used to assure and improve cell homing and reach ischemic and hypokinetic ventricular areas.
Objective: Herein we show our outcomes using ABMNC in chronic heart failure (CHF)
Material and method: During May 2007 to July 2009, 20 consecutives patients, median age 62 years old (range 34-75), female/male ratio 3/17; 95% of the patients had II to III NYHA class with three patients with IV NYHA class. None of these patient were candidates for myocardial revascularization surgery neither angioplasty. Basal left ventricular ejection fraction (LVEF) was 24,4% (range 12-39). After signed informed consent, a median volume of 564 ml (range 248-950) of bone marrow was obtained from iliac puncture. Leuko-concentrated was performed using HES 6% and refrigerate centrifugation under sterile conditions. Concentrated mononuclear cells were implanted by coronarography of the venous sinus and in selected coronary arteries previous occlusion of the balloon «over wire”. Median number of mononuclear and CD34+ cells infused were 1,6*109 and 2,21*107 respectively.
Results: During and after the procedures no arrhythmias or increase in enzymes or haemodinamic changes were observed. After a median time of 20,1 months, ABMMC led to significant improvement in functional NYHA class. Median ejection fraction improved significantly to 35,1% (p=0.003). Among 18 evaluable patients, 13 (72%) reduced at less one NYHA class and 4 stayed at the same NYHA class, only one patient increase one NYHA class. There was no correlation between cells counts and NYHA or LVEF improvement.
Conclusion: Unselected ABMNC transplantation for CHF is feasible and safe; allows to infuse large volume of cells in quite poor irrigated coronary vessels. This study suggests the potential improvement of symptoms, functional capacity, myocardial perfusion and contractility of ABMNC transplantation in CHF.
Patel AN, Geffner RL, Fernandez V, et al. Cardithoraxis Surgery University of Pittsburg, Benetti Foundation rosario Argentina,Baylor Univ. Medical Center Dallas Texas. Surgical treatment for congestive Heart Failure using Autologous Adult Stems cells transplantation. In impression Juornal Cardiothoraxis.
Stem cell therapy for acute myocardial infarction through retrograde coronary perfusion: a new technique. Stans Murad Netto, MD,PhD; Roberto Fernandez Viña, MD, Rogério Moura, MD; Antônio Manoel Neto, MD; Neison Duarte, MD; Fernando Barreto, MD; André Jensen, MD, MD; Jorge Saslavsky, MD; Marcelo Fernández Viña, MD; Luiz Martins Romeo, MD,PhD; José Geraldo Amino, MD. Instituto do Coração e da Criança do Rio de Janeiro – Rio de Janeiro - Brasil Fundacion Don Roberto Fernandez Viña/ Centro Cardiovascular - San Nicolas – ArgentinaGeorgetown University ( Department of Oncology and Imunology ) – Washington-EUA Universidade Federal Fluminense - UFF - Niterói – Brasil Presentado en Sociedad Brasilera de Cardiologia 2003 Diciembre