Cardiovascular Research Advance Access first published online on July 3, 2009
This version [Corrected Proof] published online on July 23, 2009
Cardiovascular Research, doi:10.1093/cvr/cvp229
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A new transmyocardial degradable stent combined with growth factor, heparin, and stem cells in acute myocardial infarction
1 Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
2 Department of Surgery, TEDA International Cardiovascular Hospital, No. 61, Third Avenue, TEDA, Tianjin 300457, China
3 Department of Nuclear Medicine, TEDA International Cardiovascular Hospital, Tianjin, China
4 Department of Ultrasound, TEDA International Cardiovascular Hospital, Tianjin, China
5 Institute of Basic Medical Sciences, Center of Excellence in Tissue Engineering
6 Institute of Biomedical Engineering, Peking Union Medical College, Beijing, China
7 TEDA International Cardiovascular Hospital, Nankai University Medical College, Tianjin, China
8 Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
9 Starr Academic Center, Providence Heart & Vascular Institute, Oregon Health & Science University, Portland, OR, USA
* Corresponding authors. Tel: +86 22 6520 9089; fax: +86 22 6520 8732. E-mail address: liuxc{at}tedaich.com (X.-C.L.); gwhe{at}cuhk.edu.hk (G.-W.H.)
Aims: We developed a new method—transmyocardial drilling revascularization (TMDR) with absorbable stent incorporated with basic fibroblast growth factor (bFGF) and heparin. The present study tested the effect of this method with transplantation of bone marrow-derived stem cells (BMSCs) in acute myocardial infarction.
Methods and results: Infarction was produced in mini-swine by ligating the left anterior descending (LAD) coronary artery. TMDR of 3.0 mm in diameter was made by mechanical drilling in the infarcted area. The animals that had LAD ligation were divided into six groups according to the procedures followed (n = 6 in each): control; T (TMDR); C (cell implantation); TS (TMDR+stent implantation); TC (TMDR+cell implantation); TSC (TMDR+stent implantation+cell implantation). Left ventricular (LV) function, myocardial perfusion, vascular density, and histological and morphological analyses were evaluated pre-operatively and at 30 min and 6 weeks post-operatively. Six weeks after operation, the above indices were significantly better in the TSC group than in other groups (P < 0.001 compared with the control group, and P < 0.05 or 0.01 compared with the TS and TC groups), although TS and TC also showed better results than the control group (P < 0.05).
Conclusion: We have demonstrated in a pig model that an intramyocardial stent implanted with slow release of bFGF, heparin, and BMSC transplantation may significantly increase LV function, cardiac blood flow, and vascular density. Therefore, the present study may provide a new method for the surgical treatment of myocardial infarction.
KEYWORDS Myocardial infarction; Transmyocardial revascularization; Heparin; Basic fibroblast growth factor; Stem cell transplantation
Time for primary review: 31 days