Direct minimally invasive intramyocardial injection of bone marrow-derived AC133+ stem cells in patients with refractory ischemia: Preliminary results

Giulio Pompilio, G. Steinhoff, A. Liebold, M. Pesce, F. Alamanni, M. C. Capogrossi, P. Biglioli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Bone marrow-derived stem cells (BMSC) may represent a viable option for patients with myocardial ischemia refractory to conventional treatments. Material and Methods: In 5 patients (4 males and 1 female, mean age 64 ± 8 years) with untreatable angina pectoris (Canadian Cardiovascular Society Class III/IV), myocardial segments with stress-induced ischemia as assessed by gated single-photon emission computed tomography were injected with 4 to 12 million CD133+ BMSC. Cells were injected into the myocardium (2 anterior, 2 lateral, 1 inferior wall) through minimally invasive approaches (left minithoracotomy [n = 4] and subdiaphragmatic approach [n = 1]). At baseline, at 6 months and at 1 year of follow-up, an exercise test, gated single-photon emission computed tomography (SPECT), 2-D echocardiography and coronary angiography were performed to assess exercise capacity, myocardial perfusion, LV function and coronary anatomy. Results: Intramyocardial injection of autologous CD133+ BMSC cells was safe. No early or long-term complications were observed. After an average of 3.8 weeks from cell inoculation, all patients experienced a significant improvement of CCS class (from 3.8 to 1.8 at 6 months) and serial SPECT documented improvements of rest and stress perfusion in the injected territories at 6 months from operation. In 3 cases, coronary angiography showed an increase in the collateral score of the target areas. Clinical improvements still persist unchanged in 4 out of 5 cases at a mean of 36.5 months postoperatively. Conclusions: After stand-alone BMSC transplantation for refractory myocardial ischemia, we observed long-term clinical and perfusion improvements in the absence of adverse events.

Original languageEnglish
Pages (from-to)71-76
Number of pages6
JournalThoracic and Cardiovascular Surgeon
Volume56
Issue number2
DOIs
Publication statusPublished - Mar 2008

Keywords

  • Coronary artery disease
  • Refractory ischemia
  • Stem cells

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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