Recommendations for Successful Training on Methods of Delivery of Biologics for Cardiac Regeneration
A Report of the International Society for Cardiovascular Translational Research
Nabil Dib, Philippe Menasche, Jozef J. Bartunek, Andreas M. Zeiher, Andre Terzic, Nicolas A. Chronos, Timothy D. Henry, Nicholas S. Peters, Francisco Fernández-Avilés, Magdi Yacoub, Timothy A. Sanborn, Anthony DeMaria, Richard A. Schatz, Doris A. Taylor, Shmuel Fuchs, Silviu Itescu, Leslie W. Miller, Jonathan H. Dinsmore, George D. Dangas, Jeffrey J. Popma, Jennifer L. Hall and David R. Holmes Jr
Procedure of Percutaneous Intracoronary Transplantation of Bone Marrow-Derived Stem Cells
For intracoronary delivery of the cells, an over-the-wire angioplasty balloon catheter oversized by 0.5 mm is used (A and B). After positioning at the site of the former infarct-related coronary occlusion where the stent had been implanted, the balloon is inflated at low pressure (2 to 4 atms) to block blood flow (B). Then, the guidewire is removed, and the bone marrow-derived stem cells suspension is infused through the internal lumen of the balloon under stop-flow conditions (C). Bone marrow-derived stem cells are infused with a pump at 1 to 2 ml/min during periods of 3 min of inflation and cell infusion alternating with 1 min of de-inflation and reperfusion until the total dose of cells is given to the patient. Integrity of the coronary artery used for transplantation and blood flow perfusion in the supplied myocardial area are checked after the procedure (D).
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