ADMINISTRATION OF UNFRACTIONS AUTOLOGOUS BONE MARROW IN CHRONIC CORONARY DISEASE ( ARGENTINA PIONEER EXPERIENCE)
ADMINISTRATION OF UNFRACTIONS AUTOLOGOUS BONE MARROW IN CHRONIC CORONARY DISEASE ( ARGENTINA PIONEER EXPERIENCE)
Author Block Fernandez Vina, Roberto J.1, Saslavsky, Jorge2, Andrin, Oberdan3, Vrsalovic, Francisco3, Fernandez Vina, Federico4, Camozzi, Liliana5, Ferreira da Silva Lima, Janaina4, Murad Neto, Stans6, Tuma, Jorge7
1Stem cels therapy and Interventional Cardiology, Fernandez Vina Foundation Argentina and Maimonides University Buenos Aires Argentina, Buenos Aires, Argentina, 2Hematology, Medicine School University of Rosario Argentina, Rosario, Argentina, 3Stem cels therapy and Interventional Cardiology, Fernandez Vina Foundation Argentina & San icolas Private Hospital, Buenos Aires, Argentina, 4Stem cels therapy and Interventional Cardiology, Fernandez Vina Foundation Argentina & San Nicolas Private Hospital, Buenos Aires, Argentina, 5Laboratory Clinic, Fernandez Vina Foundation Argentina, Buenos Aires, Argentina, 6Stem cels therapy and Interventional Cardiology, Instituto de Cardilogia de Post Grado Rio De Janeiro Brasil, Rio de Janeiro, Brazil, 7Stem cels therapy and Interventional Cardiology, La Maison de Sante & San Felipe Clinic Lima, Lima, Peru
Abstract:
Objetives: Unfractions Autologous Bone Marrow may be used in the treatment of chronic myocardial ischemia and myocardial infarction. Method 70 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 of the both ventricles. Echocardiograms showed extensive Myocardiopathy with Diastoles diameter oscillating form 65 to 73mm and the FEjection oscillating between 32% and 34%. Stress test revealed in 52 patients anterior wall and apical necrosis with severe perinecrótic ischemia; in 29 patients inferior and lateral necrosis; and 63 multiple ischemic areas, Ventriculography revealed increment of EDVolume and ESystole Volume, with FE oscillating between 32% and 36%. The Cell Implant was made by “Retrograde Injection through the Sinus Coronary Vein totally occluded with balloon”. The volume injected was 150cc The average of total mononuclears cells implanted 9 x 10p8. 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 improvement of the perfusion in 62 patients of the perinecrótic and diffuse ischemic areas, 65 patients were subjected to Ventriculography after 360 days and it was observed that the FE improved up to 48%. Conclusions: The injection of Unfractions Autologous Bone Marrow 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 after a period of 4 year. 45patients have achieved 2 year of evolution and they are asymptomatic or in functional class I-II.
Author Block Fernandez Vina, Roberto J.1, Saslavsky, Jorge2, Andrin, Oberdan3, Vrsalovic, Francisco3, Fernandez Vina, Federico4, Camozzi, Liliana5, Ferreira da Silva Lima, Janaina4, Murad Neto, Stans6, Tuma, Jorge7
1Stem cels therapy and Interventional Cardiology, Fernandez Vina Foundation Argentina and Maimonides University Buenos Aires Argentina, Buenos Aires, Argentina, 2Hematology, Medicine School University of Rosario Argentina, Rosario, Argentina, 3Stem cels therapy and Interventional Cardiology, Fernandez Vina Foundation Argentina & San icolas Private Hospital, Buenos Aires, Argentina, 4Stem cels therapy and Interventional Cardiology, Fernandez Vina Foundation Argentina & San Nicolas Private Hospital, Buenos Aires, Argentina, 5Laboratory Clinic, Fernandez Vina Foundation Argentina, Buenos Aires, Argentina, 6Stem cels therapy and Interventional Cardiology, Instituto de Cardilogia de Post Grado Rio De Janeiro Brasil, Rio de Janeiro, Brazil, 7Stem cels therapy and Interventional Cardiology, La Maison de Sante & San Felipe Clinic Lima, Lima, Peru
Abstract:
Objetives: Unfractions Autologous Bone Marrow may be used in the treatment of chronic myocardial ischemia and myocardial infarction. Method 70 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 of the both ventricles. Echocardiograms showed extensive Myocardiopathy with Diastoles diameter oscillating form 65 to 73mm and the FEjection oscillating between 32% and 34%. Stress test revealed in 52 patients anterior wall and apical necrosis with severe perinecrótic ischemia; in 29 patients inferior and lateral necrosis; and 63 multiple ischemic areas, Ventriculography revealed increment of EDVolume and ESystole Volume, with FE oscillating between 32% and 36%. The Cell Implant was made by “Retrograde Injection through the Sinus Coronary Vein totally occluded with balloon”. The volume injected was 150cc The average of total mononuclears cells implanted 9 x 10p8. 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 improvement of the perfusion in 62 patients of the perinecrótic and diffuse ischemic areas, 65 patients were subjected to Ventriculography after 360 days and it was observed that the FE improved up to 48%. Conclusions: The injection of Unfractions Autologous Bone Marrow 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 after a period of 4 year. 45patients have achieved 2 year of evolution and they are asymptomatic or in functional class I-II.
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