10/03/2022
South American Experience of Administration of Autologous Bone Marrow Stem Cells as Treatment of Patients with Chronic Coronary Disease with Angina or Cardiac Failure and Not Options of Surgical Revascularization. Six years follow up
R. J. Fernandez Vina1,2,3, J. Saslavsky2,Stans Murad Neto4, R. F. Fernandez Viña1, F. Vrsalovick1, P. Andres1, L. Camozzi1, J. Ferreira da Silva Lima, ,1San Nicolas Clinic Fernandez Viña Foundation, San Nicolas (Buenos Aires), ARGENTINA, 2Universidad National de Rosario, Rosario, ARGENTINA, 3Universidad Maimonides Buenos Aires, Buenos Aires,4 Instituto Post Graduacion de Cardiologia de Rio de Janeiro Brasil.
Objetives: Autologous Bone Marrow Stem Cells may be used in the treatment of chronic myocardial ischemia and myocardial infarction. Method 75 patients with refractory angina or cardiac failure and no possibility of surgical revascularization were included. The age of patients,46 men and 24 women, oscillated between 53 and 71 years old. Electrocardiograms showed MI Sequel in different walls. Echocar-diograms showed extensive Myocardiopathy with Diastoles diameter oscillating form 65 to 73mm and the FEjection between 32% and 34%. Stresstest revealed in 52 patients anterior and apical necrosis with severe perinecrótic ischemia; in 29 patients inferior-lateral necrosis; and 63 multiple ischemic areas, Ventricu-lography revealed increment of EDVolume and ESVolume, with FE oscillating between 32% and 36%.The ABMSC were harvest from iliac crest, the sample was processed using density gradient separation method, obtained 200ml of CD34(+) CD38(-)mean number of cells 22x106.The Cell Implant was made by Retrograde Injection through the Sinus Coronary Vein totally occluded.The volume injected was 150cc Follow up: After a period of three month a progressive increase of sectors contractility was observed in the echocardiograms. After 180 days it was observed that FE had improved between 38% and 51%. Scintigraphy controls revealed impro-vement of the perfusion in 62 patients of the perinecrótic and diffuse ischemic areas, 65 patients were subjected to Ventriculography after six years and it was observed that the FE improved up to 48% is mantained. Conclusions: The injection of ABMS has demonstrated improvement of the perfusion, surely through angiogenesis that produced the FE increase, objectived by echocardiograms,and Ventriculography. 92% of the patients, showed an improvement of the contractility of border zone of scars. It was not observed any progression of coronary occlusive disease.65 patients have achieved 6 year of evolution and are asymptomatic or in functional class I-II.