Bypass Grafts and Cell Transplant in Heart Failure with Low Ejection Fraction

Abstract

From June 2004 to October 2007, 34 patients with chronic heart failure and low ejection fraction underwent surgical revascularization; 23 received bypass grafting plus transplantation of bone marrow-derived stem cells (study group) and 11 had revascularization only (control group). The stem cells were implanted into nonviable myocardial areas, bypass grafting was performed in viable myocardial areas. In the study group, the ejection fraction increased from the baseline 26.4% ± 4% to 37.3% ± 11.5% after 26 months. In the control group, ejection fraction increased from 29% ± 2% to 31.5% ± 4.3% after 27 months. The improvement in the study group was significantly greater than that in the control group. Functional class improved significantly from 3.2 to 1.2 in the study group vs. 3.0 to 2.3 in the control group. Stem cell transplantation associated with bypass grafting is feasible and safe in patients with chronic heart failure with low ejection fractions, and it improves ventricular systolic function and functional class.

Functional recovery of patients with ischemic cardiomyopathy treated with coronary artery bypass surgery and concomitant intramyocardial bone marrow mononuclear cell implantation: A long term follow-up study

“…Postoperatively, the procedure contributes to better quality of life and further reduces cardiovascular mortality. Postoperative improvement in the NYHA class is evident for all the patients, which is consistent with other studies and follow-up periods of 6-12 months 14,31,32 . Also, functional capacity of patients in the BMMNC group was significantly better according to the results achived by 6-MWT in all time frames during a long-term follow-up.…”

Clinical Trials of Cardiac Repair with Adult Bone Marrow- Derived Cells

“…In clinical trials, BMCs have been delivered successfully via intracoronary [18, 24, 25, 28, 30, 37, 40, 41, 44, 49, 50, 56, 83, 96, 100, 101], transepicardial (during CABG) [26, 27, 60, 80–82, 102], transendocardial [23, 31, 38, 39, 68, 69], as well as intravenous [52] routes. Each of these approaches presents specific advantages depending on the cell type and patient characteristics.…”

The Aryl Hydrocarbon Receptor Relays Metabolic Signals to Promote Cellular Regeneration

“…These studies might have an immediate impact on clinical applications. For instance, they may provide a rationale for the reported clinical improvement of patients with chronic heart failure with low ejection fractions that received bypass grafting plus transplantation of bone marrow-derived stem cells [ 64 , 65 ] where the presence of stem cells from a different tissue and the absence of its native niche seem to favor regeneration of cardiac tissue.…”