Document Detail


The combined use of transmyocardial laser revascularisation and intramyocardial injection of bone-marrow derived stem cells in patients with end-stage coronary artery disease: one year follow-up.
MedLine Citation:
PMID:  23788089     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: There are a growing number of patients with end-stage coronary artery disease (CAD) and refractory angina. Angiogenesis may be induced by intramyocardial injection of autologous bone marrow stem cells, intensified by inflammationaround channels performed by laser.
AIM: To assess the effect of a combined treatment consisting of transmyocardial laser revascularisation (TLMR) and intramyocardialinjection of bone-marrow derived stem cells (bone marrow laser revascularisation, BMLR) in patients with refractoryangina one year after the procedure.
METHODS: Five male patients (age 49-78 years) with end-stage diffuse CAD, severe angina (CCS III/IV) despite intensive medicaltherapy and disqualified from prior coronary artery bypass grafting (CABG) or percutaneous coronary intervention wereincluded. After heart exposure, at sites where CABG was impossible, TMLR was performed with the Holmium: YAG laser combinedwith injection of 1 mL of bone marrow concentrate into the border zone of a laser channel using a Phoenix handpiece.
RESULTS: No deaths in the follow-up period were observed. All patients were in I CCS Class. One year after the procedure,left ventricular (LV) segments treated by BMLR tended to demonstrate stronger myocardial thickening compared to baseline(53.0 ± 7.5% vs. 45.0 ± 9.5%; p = 0.06). Using late gadolinium-enhanced imaging, new myocardial infarction was foundafter one year only in one LV segment treated by BMLR. The BMLR treated regions in the remaining subjects, as well asregions subtended by left internal thoracic artery in two subjects, did not show new myocardial infarction areas. In contrast,all subjects who underwent only BMLR procedure revealed new and/or more extensive myocardial infarct in regions nottreated by BMLR.
CONCLUSIONS: Intramyocardial delivery of bone marrow stem-cells together with laser therapy is a safe procedure, with improvementin quality of life during follow-up. One year after the procedure, myocardial regions where BMLR was performedtended to demonstrate stronger myocardial thickening observed in cardiac magnetic resonance imaging.
Authors:
Janusz Konstanty-Kalandyk; Jacek Piątek; Tomasz Miszalski-Jamka; Paweł Rudziński; Zbigniew Walter; Krzysztof Bartuś; Małgorzata Urbańczyk-Zawadzka; Jerzy Sadowski
Related Documents :
11521129 - Myocardial scintigraphy correlates poorly with coronary angiography in the screening of...
23956269 - Single-stage hybrid coronary revascularization with long-term follow-up.
23305549 - Effect of septal ablation on regional diastolic dysfunction and diastolic asynchrony in...
23290499 - Prognostic value of coronary and microvascular flow reserve in patients with nonischemi...
24408069 - The relationship between gensini score and st-segment resolution in patients with acute...
17399809 - Coronary angiography in lebanon: use and overuse.
2093379 - A new semiautomated algorithm to quantify holter-detected myocardial ischemia: prelimin...
18368289 - Leukocytoclastic vasculitis with severe cardiac involvement in an infant: a case report.
10406689 - Heparin-coating of coronary stents.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  71     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2013  
Date Detail:
Created Date:  2013-06-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  485-92     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Krakow, Poland. jakonstanty@poczta.onet.pl.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Assessment of the relationship between red cell distribution width and cardiac syndrome X.
Next Document:  Body mass, behaviours and social/health situation in diabetes patients at the level of primary medic...