Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2005;32(4):598-601.

Myoangiogenesis after cell patch cardiomyoplasty and omentopexy in a patient with ischemic cardiomyopathy

Syde A Taheri  1 , Hasmat Ashraf, Michael Merhige, Robert S Miletich, Sateesh Satchidanand, Chetan Malik, John Naughton, Qiang Zhao
Affiliations
Case Reports

Myoangiogenesis after cell patch cardiomyoplasty and omentopexy in a patient with ischemic cardiomyopathy

Syde A Taheri et al. Tex Heart Inst J. 2005.

Abstract

We describe a procedure to promote angiogenesis and impregnation of skeletal myoblast into infarcted myocardium. At the completion of coronary artery bypass surgery, the midline sternotomy incision was extended to open the abdomen, and the greater omentum was tailored to reach the myocardium. Four pieces of autologous rectus muscle were applied to the infarcted left ventricle. This implantation was reinforced by the greater omentum. Incisions were closed in the usual manner. Postoperatively, the patient showed significant improvements in left ventricular ejection fraction (from 0.15 to 0.40) and in exercise tolerance (from 3 METs to 6 METs, or 100%). Computed tomographic angiography and positron emission tomography demonstrated improved myocardial viability and vascularity in the ischemic segments of the left ventricle. Omentopexy and cell patch cardiomyoplasty in conjunction with coronary artery bypass surgery may stimulate myogenesis and angiogenesis in avascular, dyskinetic scar tissue of left ventricle; in this preliminary study, this procedure appeared to improve the functional capacity of the left ventricle.

PubMed Disclaimer

Figures

None
Fig. 1 Polar maps of representative left anterior descending coronary artery ligation in the rabbit. Left and right panels are ammonia (NH3) and fluorodeoxyglucose (FDG) positron emission tomographic polar maps, respectively. Closely matched defects of perfusion and glucose metabolism are noted in the apex and in the distal anteroseptal wall, although the FDG defect is larger.
None
Fig. 2 Ammonia (NH3) and fluorodeoxyglucose (FDG) polar maps of a representative cellular patch cardiomyoplasty (CEPAC) rabbit. Myoplasty was performed at the same surgical session as the left anterior descending coronary artery ligation. Note the protective effect of CEPAC on apex and anterior wall perfusion (FDG image) and metabolism (NH3 image).
None
Fig. 3 Photomicrograph (H&E, orig. x 100) shows regeneration of transplanted skeletal muscle (black arrow) penetrating into infarcted myocardium. The white arrow depicts regenerated cardiac muscle.
None
Fig. 4 Perfusion: The postoperative rubidium (Rb) study shows improvement in resting myocardial perfusion in the basal posterior wall, the inferior segment, and the basal septum, with persistently reduced perfusion at the apex. Metabolism: Postoperative viability study using fluorodeoxyglucose (FDG) demonstrates a moderate-size nontransmural infarct, which involves 15% of total left ventricular mass in the inferoapical and apicoseptal segments. There is improvement in FSG uptake in the inferobasal and apicolateral segments, the site of skeletal muscle grafting.
None
Fig. 5 Computed tomographic angiogram shows new capillaries originating from the omentum and extending into the myocardium.
See this image and copyright information in PMC

References

    1. Loebe M, Soltero E, Thohan V, Lafuente JA, Noon GP. New surgical therapies for heart failure. Curr Opin Cardiol 2003;18:194–8. - PubMed
    1. McCarthy PM. Synergistic approaches in the surgical treatment of heart failure: complex solutions for complex problems. Semin Thorac Cardiovasc Surg 2002;14:187–9. - PubMed
    1. O'Connor CM, Velazquez EJ, Gardner LH, Smith PK, Newman MF, Landolfo KP, et al. Comparison of coronary artery bypass grafting versus medical therapy on long-term outcome in patients with ischemic cardiomyopathy (a 25-year experience from the Duke Cardiovascular Disease Databank). Am J Cardiol 2002;90:101–7. - PubMed
    1. Hausmann H, Topp H, Siniawski H, Holz S, Hetzer R. Decision-making in end-stage coronary artery disease: revascularization or heart transplantation? Ann Thorac Surg 1997; 64:1296–302. - PubMed
    1. Menasche P, Hagege AA, Vilquin JT, Desnos M, Abergel E, Pouzet B, et al. Autologous skeletal myoblast transplantation for severe postinfarction left ventricular dysfunction. J Am Coll Cardiol 2003;41:1078–83. - PubMed

Publication types