Background-It is not clear how many skeletal myoblsts (SM) can survive and exert beneficial effects in the host myocardial infarction (MI) area. We assessed the hypothesis that a large number of SM can replace the MI area with reverse left ventricular (LV) remodeling. Methods and Results-MI was created by left coronary artery ligation in male Lewis rats. Four weeks after ligation, 45 rats had skeletal myoblast transplantation in the MI area. They were randomized into 3 groups according to the number of SM: group I (nϭ15), 5ϫ10 7 ; group II (nϭ15), 5ϫ10 6 ; and group III (nϭ15), 5ϫ10 5 cells. Donor SM were obtained from neonatal Lewis rats and directly used without expansion. Another four weeks later, all rats were sacrificed following hemodynamic assessment. All heart sections were stained with anti-fast skeletal myosin heavy chain (FSMHC) antibody to determine the spacial extent of donor myocytes. Results-Four weeks after transplantation, LV diastolic dimension was decreased, fractional area change was increased, and MI size was decreased maximally in group I. Histological study showed that donor cells positive for FSMHC occupied the MI area with nearly normal wall thickness in group I, in which estimated volume of donor-derived muscle tissue was 40 mm 3 . In the other groups, FSMHC-positive cells were found only partly in the MI area.

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base (ACSD) to examine risk factors for outcomes after surgical repair of post-MI VSD. 9 In Japan, the Japan Adult Cardiovascular Surgery Database (JCVSD) was established in 2000. 10 Thus, in the present study, we report a Japanese multicenter experience of surgical repair of post-MI VSD using the JCVSD. Methods Data Collection The JCVSD includes 255 variables that are nearly identical to those in the database of the STS. Informed consent to register clinical data in the JCVSD was obtained from each patient. The JCVSD Organization Review Board approved the present study. From the JCVSD, we identified adults (age ≥18 years) undergoing surgical repair of a post-MI VSD from January 2008 to December 2014. Eligible patients were identified by an affirmative response in the JCVSD data field for MI. Patients who underwent concomitant procedures such as coronary revascularization or valvular surgeries were V entricular septal defect (VSD) is a rare but lethal complication of acute myocardial infarction (MI). 1 For patients treated medically, the mortality of post-MI VSD exceeds 90%. 2 With the development of acute reperfusion strategies for MI, the incidence of post-MI VSD occurs in less than 1% of patients sustaining MI. 1,2 Despite significant improvements over the past 2 decades in overall mortality for patients with acute MI, the outcome of patients who develop post-MI VSD remains poor. Even for patients who are treated surgically, mortality has been high, ranging between 19% and 60% in patients. 1-7 However, most of these reports involved single-center experience with small sample sizes. To improve the outcomes, further study from a larger multicenter experience may be necessary. Recently, several studies with large sample sizes from national databases have been reported from Europe and the USA. A single national registry report from Sweden reported 189 patients treated during a 7-year span. 8 National registry data have been provided by the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Data

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