Preoperative mobilization of bone marrow-derived cells followed by revascularization surgery: early and long-term outcome.
| Autor: | Dato GM; Division of Cardiac Surgery, Mauriziano Umberto I Hospital of Turin, Turin, Italy., Sansone F, Omedé P, Zingarelli E, Flocco R, Punta G, Parisi F, Forsennati PG, Bardi GL, Del Ponte S, Casabona R, Tarella C |
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| Jazyk: | angličtina |
| Zdroj: | The International journal of artificial organs [Int J Artif Organs] 2012 Jan; Vol. 35 (1), pp. 67-76. |
| DOI: | 10.5301/ijao.5000021 |
| Abstrakt: | Introduction: Coronary artery disease (CAD), along with its main complications such as acute myocardial infarction (AMI) and congestive heart failure (CHF), remains a serious worldwide problem and affects many patients despite the improvement of medical treatment. The possibility of the replacement of the infarcted areas by the re-generation of the myocardial cells has been long discussed and the mobilization of the stem cells from bone marrow (BMCs) to the peripheral blood (PB) induced by cytokines, represents a potential pathway to activate the regenerative process. Patients and Methods: We describe BMC mobilization and direct/indirect revascularization in 15 patients operated on for coronary artery bypass grafting (CABG) and/or mitral valve surgery and/or ventricular remodeling combined to multiple trans-myocardial punctures (Sen technique) in ungraftable non-viable fibrotic areas. Results: Peak values of circulating BMCs were recorded between day +4 and day +6. We had no in-hospital (0-30 days) mortality. All the patients were discharged from the ICU after a median period of 2 days while the in-hospital length of stay was 10.5+4.2 days (range 7-21) and all patients were discharged in good clinical condition. There were two sudden deaths over the mid-term, at postoperative day (POD) 32 and 45 respectively. Conclusions: Our study suggests that the combination of BMC mobilization and CABG may be safely performed. However, considering the small series, final conclusions about the benefit of this procedure must await a larger prospective study comparing the role of cytokines alone, myocardial perforation, and the combination of both. |
| Databáze: | MEDLINE |
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