Loss of myocytes as a result of coronary artery occlusion is a major effect in the genesis of cardiac failure. Laboratory results of experimental cell patch cardiomyoplasty and omentopexy show regeneration, viability, synchronous contraction and migration of stem cells into infarcted myocardium. These encouraging results prompted us to use autologous cell patch cardiomyoplasty and omentopexy during coronary bypass on 13 patients (NYHA-II, III); 11 male, 2 female. There has been no mortality or morbidities. All patients had improved ejection fraction PET scanning and CT angiography revealed viable transplanted tissue and new angiogenesis from greater omentum into myocardium. Average Age 65 years
Following coronary bypass, the upper abdomen was open via midline incision to expose and tailor the greater omentum to reach the mediastinum. Six pieces of rectus muscle measuring 1 ½ x 1 ½ x 2 cm obtained, applied and sutured to dyskinetic ventricular wall, reinforced by suturing the greater omentum over the muscle patches to the myocardium.
All had increased daily activities free from chest pain and work capacity showed marked improvement with exercise testing. Individualized follow-up illustrates evidence of synchronous contraction of cell patches, higher ejection fraction, and improved perfusion with viability in grafted scar tissue proven by positron emission tomography (PET) and CT angiography.
Cell patch Cardiomyoplasty and omentopexy in conjunction with coronary bypass seems to limit fraction remodeling of the left ventricle, increase ejection fraction and improve contraction of dyskinetic ventricular wall. It has revealed viable regenerated muscle with increased perfusion, which is determined by PET scanning.
Due to encouraging results from segmental treatment of dyskinetic myocardium, cell patch cardiomyoplasty may have value for surgical treatment of global cardiomyopathy.
S.A. Taheri, None.