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Thorac Cardiovasc Surg 2010; 58(1): 11-16
DOI: 10.1055/s-0029-1186199
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

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

J. Babin-Ebell1 , H.-H. Sievers1 , E. I. Charitos1 , H. M. Klein2 , F. Jung3 , A.-K. Hellberg3 , R. Depping4 , H. A. Sier1 , J. Marxsen5 , S. Stoelting5 , E. G. Kraatz1 , K. F. Wagner6
  • 1Cardiac and Thoracic Vascular Surgery Clinic, University of Luebeck, Luebeck, Germany
  • 2Cardiac Surgery Clinic, University of Düsseldorf, Düsseldorf, Germany
  • 3Anesthesiology Clinic, University of Luebeck, Luebeck, Germany
  • 4Department of Physiology, University of Luebeck, Luebeck, Germany
  • 5Hematology and Oncology Clinic, University of Luebeck, Luebeck, Germany
  • 6Anesthesiology Clinic (KFW), Suedstadt Clinic Rostock, Rostock, Germany
Further Information

Publication History

received Nov. 5, 2008

Publication Date:
13 January 2010 (online)

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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.

Key words

heart disease - cardiomyopathy - myocardial infarction

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MD Efstratios I. Charitos

Cardiac and Thoracic Vascular Surgery Clinic
University of Lübeck

Ratzeburger Allee 160

23538 Lübeck

Germany

Phone: + 49 45 15 00 47 63

Fax: + 49 45 15 00 20 51

Email: efstratios.charitos@gmail.com

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