Cell-Based Therapy for Myocardial Dysfunction After Fontan Operation in Hypoplastic Left Heart Syndrome.
Cell-Based Therapy for Myocardial Dysfunction After Fontan Operation in Hypoplastic Left Heart Syndrome.
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DOI：
10.1016/j.mayocpiqo.2017.07.002
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发表时间：
2017-09
期刊：
影响因子：
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通讯作者：
Wanek Program Regenerative Medicine Pipeline
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文献类型：
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作者：
Qureshi MY;Cabalka AK;Khan SP;Hagler DJ;Haile DT;Cannon BC;Olson TM;Cantero-Peral S;Dietz AB;Radel DJ;Taggart NW;Kelle AM;Rodriguez V;Dearani JA;O'Leary PW;Wanek Program Regenerative Medicine Pipeline
单室先天性心脏病丰坦姑息治疗后心肌功能障碍是一个具有挑战性的临床问题。药物治疗的效果有限，心脏移植是最终的治疗步骤。细胞疗法正在发展成为治疗心力衰竭的新方法。使用再生治疗策略治疗先天性心脏病的1期临床试验正在进行中。我们报告第一例自体骨髓源性单核细胞给药治疗心室功能障碍，23年后Fontan手术患者左心发育不全综合征。通过心导管将细胞送入冠状动脉循环。心室大小减小，反映心室功能的几个参数改善，在细胞递送后3个月变化最大。这种再生治疗方案可能有助于延缓和预防心脏移植。
Myocardial dysfunction after Fontan palliation for univentricular congenital heart disease is a challenging clinical problem. The medical treatment has a limited impact, with cardiac transplant being the ultimate management step. Cell-based therapies are evolving as a new treatment for heart failure. Phase 1 clinical trials using regenerative therapeutic strategies in congenital heart disease are ongoing. We report the first case of autologous bone marrow–derived mononuclear cell administration for ventricular dysfunction, 23 years after Fontan operation in a patient with hypoplastic left heart syndrome. The cells were delivered into the coronary circulation by cardiac catheterization. Ventricular size decreased and several parameters reflecting ventricular function improved, with maximum change noted 3 months after cell delivery. Such regenerative therapeutic options may help in delaying and preventing cardiac transplant.