| Percutaneous transvenous cellular cardiomyoplasty. A novel nonsurgical approach for myocardial cell transplantation. | |
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MedLine Citation:
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PMID: 12798567 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The study evaluated a nonsurgical means of intramyocardial cell introduction using the coronary venous system for direct myocardial access and cell delivery. BACKGROUND: Direct myocardial cell repopulation has been proposed as a potential method to treat heart failure. METHODS: We harvested bone marrow from Yorkshire swine (n = 6; 50 to 60 kg), selected culture-flask adherent cells, labeled them with the gene for green fluorescence protein, expanded them in culture, and resuspended them in a collagen hydrogel. Working through the coronary sinus, a specialized catheter system was easily delivered to the anterior interventricular coronary vein. The composite catheter system (TransAccess) incorporates a phased-array ultrasound tip for guidance and a sheathed, extendable nitinol needle for transvascular myocardial access. A microinfusion (IntraLume) catheter was advanced through the needle, deep into remote myocardium, and the autologous cell-hydrogel suspension was injected into normal heart. Animals were sacrificed at days 0 (n = 2), 14 (n = 1, + 1 control/collagen biogel only), and 28 (n = 2), and the hearts were excised and examined. RESULTS: We gained widespread intramyocardial access to the anterior, lateral, septal, apical, and inferior walls from the anterior interventicular coronary vein. No death, cardiac tamponade, ventricular arrhythmia, or other procedural complications occurred. Gross inspection demonstrated no evidence of myocardial perforation, and biogel/black tissue dye was well localized to sites corresponding to fluoroscopic landmarks for delivery. Histologic analysis demonstrated needle and microcatheter tracts and accurate cell-biogel delivery. CONCLUSIONS: Percutaneous intramyocardial access is safe and feasible by a transvenous approach through the coronary venous system. The swine offers an opportunity to refine approaches used for cellular cardiomyoplasty. |
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Authors:
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Craig A Thompson; Boris A Nasseri; Joshua Makower; Stuart Houser; Michael McGarry; Theodore Lamson; Irina Pomerantseva; John Y Chang; Herman K Gold; Joseph P Vacanti; Stephen N Oesterle |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 41 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-06-11 Completed Date: 2003-07-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1964-71 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Division, Knight Center for Cardiac Catheterization and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Blake 950, Boston, MA 02114, USA. cathompson@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cardiomyoplasty* Cell Separation Cell Transplantation* Coronary Vessels / cytology Feasibility Studies Flow Cytometry Follow-Up Studies Green Fluorescent Proteins Heart Septum / cytology, radiography Heart Ventricles / cytology, radiography Immunohistochemistry Indicators and Reagents / metabolism Injections, Intramuscular Luminescent Proteins / biosynthesis Microscopy, Fluorescence Models, Animal Models, Cardiovascular Myocardium / cytology*, metabolism Myocytes, Cardiac / metabolism, radiography, transplantation* Swine Time Factors United States / epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Indicators and Reagents; 0/Luminescent Proteins; 147336-22-9/Green Fluorescent Proteins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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