Transmyocardial laser revascularization combined with intramyocardial endothelial progenitor cell transplantation in patients with intractable ischemic heart disease ineligible for conventional revascularization: preliminary results in a highly selected small patient cohort.

Abstract

OBJECTIVE:

Transmyocardial laser revascularization for angina relief and intramyocardial autologous endothelial progenitor cell injection for neoangiogenesis may offer a new treatment strategy for patients with intractable ischemic heart disease.

METHODS:

Transmyocardial laser revascularization and intramyocardial injection of bone marrow-derived CD133+ cells was performed in six highly symptomatic patients. Transmyocardial laser channels were created and isolated CD133+ cells were injected intramyocardially. All patients were followed up for a minimum of 6 months postoperatively.

RESULTS:

One patient died shortly after the operation due to refractory heart failure. In the five survivors, CCS class improved as well as left ventricular ejection fraction. Left ventricular end-diastolic volume and myocardial perfusion varied between the patients. All patients described a considerable improvement in quality of life postoperatively. Repeated 24-hour Holter monitoring revealed no significant arrhythmias.

CONCLUSIONS:

In this small patient cohort, intramyocardial CD 133+ cell injection combined with transmyocardial laser revascularization led to an improvement in clinical symptomatology in all patients and in left ventricular function in 4 out of 5 patients, with an unclear effect on myocardial perfusion. Caution is advised when employing this therapy in patients with severely depressed left ventricular function.

• Authors: J Babin-Ebell, H-H Sievers, E I Charitos, H M Klein, F Jung, A-K Hellberg, R Depping, H A Sier, J Marxsen, S Stoelting, E G Kraatz, K F Wagner
• Journal: The Thoracic and cardiovascular surgeon (Thorac Cardiovasc Surg) Vol. 58 Issue 1 Pg. 11-6 (Feb 2010) ISSN: 1439-1902 [Electronic] Germany
• PMID: 20072970 (Publication Type: Journal Article)

Topics

• Aged
• Combined Modality Therapy
• Endothelial Cells (transplantation)
• Female
• Humans
• Laser Therapy
• Male
• Middle Aged
• Myocardial Ischemia (surgery)
• Myocardial Revascularization (methods)
• Stem Cell Transplantation
• Stem Cells
• Treatment Outcome