Ten patients have received transplants of myocytes placed into the weakened areas of their hearts at the same time that they underwent coronary artery bypass graft surgery at the Hopital Bichat in Paris, France, according to Phillipe Menasche, MD, PhD, Professor of Thoracic and Cardiovascular Surgery at the Hopital Bichat, speaking at the 2001 Scientific Sessions of the American Heart Association in Anaheim, Calif.
“I have now operated on 10 patients with severe heart failure who had suffered myocardial infarctions,” said Dr Menasche on November 13, 2001. “Overall, it is a safe procedure. There are no particular complications related to 56 punctures to put the cells in. Some patients suffered arrhythmias 2 weeks later. I think it’s honest to say that this is a potential adverse event associated with the procedure. But it is a transient event.” Dr Menasche said he had implanted defibrillators in some patients, but the abnormal rhythm had not returned. He could not conclude as to the efficacy of the trial as yet.
“In terms of feasibility, we can be happy. Can you take a piece of muscle, grow it in 2 weeks and put it back? Yes, it can be routine,” he said. Dr Menasche implanted the cells into the scar left by the heart attack at the time of bypass surgery. “The area where the cells were implanted was not revascularized,” he said.
In a separate study, Patrick W. Serruys, MD, of the Thoraxcenter in Rotterdam, the Netherlands, said he had attempted an endovascular approach to implanting myocytes in a patient’s heart. “We thought there was a potential for an endovascular approach, using a needle coming from the inside of the heart to duplicate the work of the surgeon,” said Dr Serruys.
“The first patient has been treated with this technique using myoblasts from peripheral muscle resistant to ischemia,” he said. In addition, he said that his research team was convinced that the myoblasts were dedicated to becoming muscle and would not overproliferate. The first patient who had been treated was doing very well. “There is a modest improvement in the ejection fraction of 4 to 5%,” he said. “I am very happy with this first case.”
Dr Serruys said that the endovascular approach to the procedure is more challenging than surgery, and that even though he was using electromechanical mapping, “we are blind” during the procedure. However, he and members of his research team have had trouble growing the cells of other prospective patients in culture, and that difficulty has slowed progress in the field.