Report from Argentina
Implant and Cellular Therapy: a new option of treatment of Patients with Chronic coronary disease with intractable angina or cardiac failure without possibility of surgical revascularization.
R. J. Fernandez Vina1,2,3, J. Saslavsky2, R. F. Fernandez Vi?a1, O. Andrin1, F. Vrsalovick4, N. Muttis1, , P. Andres1, L. Camozzi9, C. D Adamo10, ,;
1San Nicolas Clinic Fernandez Vi?a Foundation, San Nicolas (Buenos Aires), ARGENTINA, 2Universidad National de Rosario, Rosario, ARGENTINA, 3Universidad Maimonides Buenos Aires, Buenos Aires.
Objetives: Adult stem cells derived from bone marrow are being used in the treatment of chronic myocardial ischemia and myocardial infarction. Method 69 patients with refractory angina or cardiac failure that had no possibility of surgical revascula-rization were included. The age of patients (66 men and 3 women) oscillated between 55 and 71 years old. Electrocardiograms showed Extensive MI Sequel in different walls of the left ventricle. Echocardiograms showed extensive Myocardiopathy with Diastoles diameter oscillating form 75 to 63mm and the FEjection oscillating between 25% and 32%. Stress test revealed in 42 patients anterior wall and apical necrosis with severe perinecr?tic ischemia; in 19 patients inferior and lateral necrosis; and 63 multiple ischemic areas, Ventriculography revealed increment of EDVolume and ESystole Volume, with FE oscillating between 22% and 30%. The Cell Implant was made by Retrograde Injection through the Sinus Coronary Vein. The average of cells implanted (CD34+ and CD3
was of 22 x 10p6. Follow up: After a period of one month a progressive increase of sectors contractility was observed in the echocardio-grams. After 120 days it was observed that FE had improved between 38% and 43%. Scintigraphy controls revealed improvement of the perfusion in the 53 patients in the perinecr?tic and diffuse ischemic areas, 48 patients were subjected to Ventriculo-graphy after 90 to 120 days and it was observed that the FE improved up to 38%. Conclusions: The cellular implants have demonstrated improvement of the perfu-sion, surely through angiogenesis that produced the FE increase, objectived by echocardiograms, and Ventriculography. 78% of the patients, showed an impro-vement of the contractility of periphery of scars. It was not observed any progression of coronary occlusive disease after a period of 2 year. 43 patients have achieved 3 year of evolution and they are asymptomatic or in functional class I.