Abstract

BONAFEDE¹, Roberto J. et al. Cardiac implant autologous bone marrow stem cells in necrotic myocardial territories. Insuf. card. [online]. 2013, vol.8, n.4, pp.157-164. ISSN 1852-3862.

Introduction. Currently, the classical concept that the heart was a non-regenerative organ has changed, by being an organ in continuous regeneration constitute strong evidence that cardiac tissue is in a continuous process of growth, death and renewal. Materials and methods. Twelve patients were protocolized from May 29, 2004 to August 30, 2007. We excluded five. Of the 7 remaining, five were evaluated by puncturing of the iliac crest from each patient under sterile conditions 60 cm³ extracted bone marrow and stem cells were obtained by sedimentation and identified by immunostaining with anti-CD34 monoclonal antibody in the flow cytometer. The assessment of myocardial viability before and after implantation was performed with PET-FDG. After the completion anastomosis, the stem cells were implanted directly by puncture nonviable territories. Results. They are expressed as percentages (categorical variables) and as mean with standard deviation (continuous variables). To assess significance in changing ejection fraction was used the Wilcoxon test. Was considered significant at p <0.05. We implanted 11 (73%) of the 15 segments non-viable were recovered 4 (36.36%). The ejection fraction of the left ventricle assessed by SPECT triggered average was 30.2 ± 4.9% in the pre procedure and 34.8 ± 9.5% in the post process, the improvement was 4.6 points (p=0.34), 60% of the patients improved. Conclusions. There is a relationship between the concentration of CD34 + (which was low 0.76% on average) and myocardial viability. The appearance of myocardial viability in 36.36% of the implanted segments was the most important finding. The method proved to be safe, effective and reproducible. The use of PET-FDG in all patients for viability assessment before and after implantation as gold standard method was evidence of tissue regeneration

Keywords : Cardiac implant; Stem cells; Heart failure; Myogenesis.

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