Autologous transplantation of bone marrow mononuclear stem cells by mini-thoracotomy in dilated cardiomyopathy: technique and early results / Transplante autólogo de células-tronco de medula óssea por mini-toracotomia: técnica e resultados iniciais
Kalil, Renato Abdala Karam; Ott, Daniele; Sant'Anna, Roberto; Dias, Eduardo; Marques-Pereira, João Pedro; Delgado-Cañedo, Andrés; Nardi, Nance Beyer; Sant'Anna, João Ricardo Michelin; Prates, Paulo Roberto; Nesralla, Ivo.
São Paulo med. j
; 126(2): 75-81, Mar. 2008. ilus, tab
Artículo
en Inglés
| LILACS | ID: lil-484513
CONTEXT AND
OBJECTIVES:
There are few studies concerning bone marrow mononuclear cell (BMMC) transplantation in cases of nonischemic dilated cardiomyopathy. This study describes a novel technique of BMMC transplantation and the results up to one year after the procedure. DESIGN ANDSETTING:
This was a case series to evaluate the safety and viability of the procedure, at Instituto de Cardiologia do Rio Grande do Sul.METHODS:
Nine patients with symptomatic dilated cardiomyopathy, functional class III/IV and left ventricular ejection fraction (LVEF) < 35 percent received BMMC (9.6 ± 2.6 x 107 cells) at 20 sites in the ventricular wall, by means of thoracotomy of length 5 cm in the fifth left intercostal space. Echocardiograms and nuclear magnetic resonance (NMR) were performed.RESULTS:
There were no major complications. The functional class results for the first six patients (preoperatively and at two, four, eight and twelve-month follow-ups, respectively) were [IV-2, III-4] to [I-5, II-1] to [I-3, II-3] to [I-2, II-3] and [I-2, II-3]. Echocardiograms showed LVEF 25.9 ± 8.2; 32.9 ± 10.4; 29.4 ± 7.2; 25.1 ± 7.9; 25.4 ± 6.8 percent (p = 0.023); and percent left ventricular (LV) fiber shortening 12.6 ± 4.4; 16.4 ± 5.4; 14.3 ± 3.7; 12.1 ± 4.0; 12.2 ± 3.4 percent (p = 0.021). LV performance variation seen on NMR was non-significant.CONCLUSION:
Intramyocardial transplantation of BMMC in dilated cardiomyopathy cases is feasible and safe. There were early improvements in symptoms and LV performance. Medium-term evaluation revealed regression of LV function, although maintaining improved functional class.
Biblioteca responsable:
BR1.1
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