Aim. To assess safety and efficacy of intramyocardial implantation of autologous bone marrow cells treated with erythropoietin in surgery for coronary artery disease (CAD).Materials and methods. Eighty patients with CAD with diffuse and (or) distal lesions of the right coronary artery were randomly assigned to two groups: patients of group 1 (n=40) underwent coronary bypass surgery, implantation of autologous bone marrow cells treated with erythropoietin into the lower wall of the left ventricle, patients of group 2 (control group, n=40) underwent bypass surgery of the left coronary artery. Evaluation of the clinical status, perfusion and contractility of the myocardium was performed initially, 6 and 12 months after surgery.Results. Six months after the operation, we found more pronounced decrease of functional class (FC) of angina and improvement in the 6-min walk distance in the main group compared with the control group.Twelve months after surgery, the severity of angina remained at the same level in both groups. In the control group, 45,2% of patients had FC I, 52,3% of patients did not have angina. In both groups, angina return was detected in 1 patient (FC III). According to the results of two-step myocardial scintigraphy with Technetril (Tc99), 6 months after surgery, a significant improvement in myocardial perfusion was observed. In the control group, after 6 months, no significant dynamics of perfusion of the lower wall of the left ventricle was detected.Twelve months after the surgical treatment of the right coronary artery in patients from the group 1 revealed a decrease in the stress defect and the stable perfusion defect. In patients from the control only a significant stress defect was found to decrease.Conclusion. The study demonstrated decrease of FCs, significant improvement in perfusion, functional state of the myocardium and 6-min walk distance in patients of group 1.
Catheter-based autologous bone marrow myocardial injection in no-option patients with advanced coronary artery disease