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Editorial
. 2022 May 5:10:185-194.
doi: 10.1016/j.xjon.2022.04.043. eCollection 2022 Jun.

Therapeutic payload delivery to the myocardium: Evolving strategies and obstacles

Tarek Shazly  1 , Arianna Smith  2 , Mark J Uline  1 , Francis G Spinale  1   3   4
Affiliations
Editorial

Therapeutic payload delivery to the myocardium: Evolving strategies and obstacles

Tarek Shazly et al. JTCVS Open. .
No abstract available

Keywords: BMC, bone marrow cell; HF, heart failure; ID, intracoronary delivery; IMD, intramyocardial delivery; IPD, intrapericardial delivery; LV, left ventricle; MI, myocardial infarct; MSC, mesenchymal stem cell; TED, transendocardial delivery; bFGF, basic fibroblast growth factor; biomaterial; cardiac; injection; local delivery; myocardium; payload.

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Figures

None
Emerging strategies for localized payload delivery to the myocardium.
Figure 1
Figure 1
Different approaches for delivery of a payload to the myocardium, particularly targeted therapeutic delivery to the myocardial infarct (MI) region. Catheter-based approach delivers the payload via the coronary artery, whereas the pericardial approach places the payload into the pericardial space/fluid. Direct myocardial delivery would be through an endocardial or epicardial approach.
Figure 2
Figure 2
Operational schematic of semiautomated system for direct intramyocardial injection in a closed-chest setting. Envisioned system components include a robotically controlled needle injection/sensor apparatus that is introduced through the chest wall and positioned near the myocardial surface under the guidance of a cardiac surgeon. Needle position/injection site specification could then be refined/aided by electrical monitoring of myocardial conductivity via an incorporated sensor, with feedback discriminating viable/nonviable myocardium (in a post-myocardial infarct context). A control system would integrate myocardial viability signals with echocardiogram (ECG)/respiratory data to automate small volume (∼100 uL) intramyocardial injection via a positive pump, with synchronization of pump displacement and ECG signal to facilitate control of injection depth.
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