Video-assisted thoracoscopic transplantation of myoblasts into the heart.
OBJECTIVE
Currently, cells are transplanted into injured myocardium either through thoracotomy for open surgical delivery or through catheterization for endoventricular or intracoronary delivery; both methods have limitations. Open surgical delivery limits the potential patient population, whereas catheter-based delivery limits the ability to visualize the injection site and confirm delivery of the cells to the appropriate region. In this study, we examine the feasibility of cell transplantation into myocardium using a minimally invasive thoracoscopic approach.


METHODS
Seven swine underwent thoracoscopic cell transplantation. Using a prototype injection device, approximately 10 million myoblasts were injected into the anterior, lateral, posterior, and apical regions of myocardium. Animals were recovered up to 7 days, and after euthanasia, hearts were explanted for histology.


RESULTS
All seven swine had successful delivery of myoblasts into the defined injection sites, as confirmed by analysis of an operative video, magnetic resonance imaging of iron-oxide-labeled cells, and histologic examination.


CONCLUSIONS
Thoracoscopic cellular cardiomyoplasty is feasible and allows the surgeon the benefits of direct visualization of the cell injection while minimizing morbidity associated with open cell delivery.
Thompson
Richard B
RB
Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Parsa
Cyrus J
CJ
van den Bos
Ewout J
EJ
Davis
Bryce H
BH
Toloza
Eric M
EM
Klem
Igor
I
Glower
Donald D
DD
Taylor
Doris A
DA
D000818:Animals; D005240:Feasibility Studies; D005290:Ferric Compounds / Q000032:analysis; D005456:Fluorescent Dyes / Q000032:analysis; D007211:Indoles / Q000032:analysis; D019028:Magnetic Resonance Imaging, Cine; D032446:Myoblasts / Q000637:transplantation*; D009206:Myocardium; D034421:Sus scrofa; D020775:Thoracic Surgery, Video-Assisted
D005290:Ferric Compounds; D005456:Fluorescent Dyes; D007211:Indoles; C000499:ferric oxide; C007293:DAPI