title: Cellular cardiomyoplasty for a patient with heart failure.
abstract: BACKGROUND
  A 73-year-old man with a history of myocardial infarction and hypertension for 5 years suffered heart failure (NYHA III-IV).
  
  
  METHODS
  2D echo indicated hypokinesia at septal, left ventricular anterior wall and apical regions. Coronary angiograms demonstrated 60% stenosis in distal left main and 99% stenosis in proximal and distal left anterior descending coronary arteries (LAD). Both proximal artery and middle left circumflex coronary artery (LC) had 90% stenosis, and diffuse stenosis of right coronary artery (RC) was found. Myocardial perfusion imaging using 99mTc-MIBI indicated defective perfusion of left ventricular apex, anterior wall and septal region and severe reduced perfusion of posterior inferior wall. Myocardial metabolic activities (18F-deoxyglucose) also showed comparable reductions. After exposing the heart, LAD, LC, and RC were all completely occluded and bypass procedure could not be completed. Autologous satellite cells were implanted without any complication and the patient had an uneventful recovery.
  
  
  RESULTS
  During the first 2 months, he remained in heart failure, and by the third month, he gradually improved and reached NYHA II. At fifth month after the procedure, significant increased ejection fraction (37.1-48.6%) and wall movement with modest reduction of left ventricular systolic diameter (48-45 mm) were observed. Imaging with 18F-deoxyglucose showed dramatic improvement in myocardial metabolic activity with similar improvement in myocardial perfusion (99mTc-MIBI).
  
  
  CONCLUSIONS
  This is the first successful case of cellular cardiomyoplasty without any conjunctional procedure for patient with severe coronary heart disease and heart failure.
authors.affiliation: The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.
authors.forename: Fumin
authors.initials: F
authors.lastname: Zhang
authors.forename: Yijiang
authors.initials: Y
authors.lastname: Chen
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Yang
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
authors.forename: Wenzhu
authors.initials: W
authors.lastname: Ma
authors.forename: Chuanfu
authors.initials: C
authors.lastname: Li
authors.forename: Race L
authors.initials: RL
authors.lastname: Kao
mesh_terms: D000368:Aged; D017690:Cell Transplantation / Q000379:methods*; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery*; D006333:Heart Failure / Q000150:complications / Q000601:surgery*; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009203:Myocardial Infarction / Q000150:complications; D032383:Myocytes, Cardiac / Q000637:transplantation*; D016896:Treatment Outcome