Korean J Thorac Cardiovasc Surg.  2004 Jul;37(7):547-552.

Autologous Bone Marrow Cell Transplantation Combined with Off-pump Coronary Artery Bypass Grafting in Ischemic Myocardium

• Yoo KJ
• Kim HO
• Kwak YL
• Kang SM
• Jang YS
• Lim SH
• Ahn JY
• Lee CY
• Kang MS

Abstract

BACKGROUND: Recently, autologous bone marrow cell transplantation (CTx) for angiogenesis and myogenesis in ischemic myocardium has been extensively investigated to improve heart functions. This study was designed to evaluate the effects of CTx with off-pump coronary artery bypass grafting (OPCAB) in patients who were not feasible for complete revascularization. MATERIAL AND METHOD: Four male patients underwent CTx and OPCAB simultaneously. Bone marrow was aspirated from iliac bone. Mean 1.5x109 mononuclear cells including mean 6.7x106 CD34+ cells and 3.7x106 AC133+ cells were obtained and concentrated with 10 cc. These cells were transplanted into non-graftable ischemic myocardium after OPCAB. The heart function of all patients were evaluated using the MIBI scan, echocardiogram and MRI preoperatively. The effects of CTx was evaluated using MIBI scan and echocardiogram at 1 month postoperatively. RESULT: An average of 2 grafts were bypassed to left anterior descending artery territory. Other territories were transplanted with isolated mononuclear cell. All patients had uncomplicated postoperative course. After 1 month follow up, there were improvement in symptom, ejection fraction (from 49% to 55%) on echocardiogram and myocardial perfusion on MIBI scan in all patients.
CONCLUSION
These preliminary data showed improvement of heart function and myocardial perfusion and also showed the feasibility and safety of combined therapy with OPCAB and CTx in ischemic myocardium. However, the effectiveness of CTx alone cannot be readily assessed. Further randomized, controlled studies are required to evaluate the effectiveness of CTx alone.

Keyword

Ischemic heart disease; Coronary artery bypass; Cell transplantation; Myocardial infarction

MeSH Terms

Arteries
Bone Marrow Cells*
Bone Marrow Transplantation*
Bone Marrow*
Cell Transplantation
Coronary Artery Bypass*
Coronary Artery Bypass, Off-Pump
Coronary Vessels*
Follow-Up Studies
Heart
Humans
Magnetic Resonance Imaging
Male
Muscle Development
Myocardial Infarction
Myocardial Ischemia
Myocardium
Perfusion
Transplants