Commentary: An innovative “CABG-patch”

Central MessageThe authors present a model of hibernating myocardium treated with CABG and an epicardial mesenchymal stem cell patch. This shows improved ventricular function but its real-world use is limited.See Article page e3. The limited. See After myocardial ischemia, consists ischemic cells that remain viable can lead to decreased contraction dysfunction.1Conti C.R. stunned myocardium: brief review.Clin Cardiol. 1991; 14: 708-712Crossref PubMed Scopus (29) Google Scholar Because the are still viable, improves after coronary revascularization.2Ando H. Tanaka J. Hisahara M. Umesue Shirota T. Effect bypass grafting onto site old infarction recovery cardiac function.Cardiovasc Surg. 1998; 6: 511-519Crossref (0) In addition revascularization improve function, there growing interest in (MSCs) aid infarcted muscle. first published report cellular cardiomyoplasty was 1999 from University Toronto.3Tomita S. Li R.K. Weisel R.D. Mickle D.A. Kim E.J. Skai et al.Autologous transplantation bone marrow damaged heart function.Circulation. 1999; 100: II247-II256PubMed Further studies suggest injecting MSCs into leads differentiation cardiomyocytes4Shake J.G. Gruber P.J. Baumgartner W.A. Senechal G. Meyers Redmond J.M. al.Mesenchymal implantation swine infarct model: engraftment functional effects.Ann Thorac 2002; 73: 1919-1925Abstract Full Text PDF (797) Scholar,5Pittenger M.F. Martin B.J. Mesenchymal their potential as therapeutics.Circ Res. 2004; 95: 9-20Crossref (1249) clinical benefit debated.5Pittenger Scholar, 6Laguna Dl Stefano Maroto L. Fulquet E. Echevarria J.R. Revilla A. al.Effect direct intramyocardial autologous sub-acute phase infarction.J Cardiovasc Surg (Torino). 2018; 59: 259-267PubMed 7Zhang F. Gao X. Yiang Z.-J. Ma W. C. Kao R.L. al.Cellular cardiomyoplasty: preliminary report.Cardiovasc Radiat Med. 2003; 4: 39-42Abstract (6) 8Chan J.L. Miller Zhou Y. Robey P.G. Stroncek D.F. Aria A.E. al.Intramyocardial patients undergoing surgical revascularization.Ann September 14, 2019; ([Epub ahead print])Google 9Perin E.C. Dohmann H.F.R. Borojevic R. Silva S.A. Sousa A.L.S. Mesquita C.T. al.Transendocardial, for severe, chronic failure.Circulation. 107: 2294-2302Crossref (1143) Stone colleagues10Stone L.L.H. Swingen Wright Qi S.S. Rassette McFalls E.O. al.Recovery using patch surgery.J 2021; 162: e3-e16Abstract (3) aim investigate utility applied at time artery graft (CABG). model, they mechanically stenosed left anterior descending artery; 12 weeks, single vessel internal thoracic artery–left performed placing containing on myocardium. They found contractile when tested inotropes microscopic level were increased number size mitochondria suggesting mechanism function. should be congratulated study novel findings. But we have several concerns believe limit applicability disease used. Although easily reproducible, single-vessel without quite More commonly, our triple-vessel complicates technical aspect placement calls question whether burden dysfunctional would overwhelm improvement seen MSC application. Secondly, all these operations under normothermic off-pump conditions. With on-pump CABG, conditions cardiopulmonary such hypothermia heightened inflammatory response affect improvements function? Finally, chose allogeneic mode delivery citing over or intracoronary injection. method limited by both type incubation time. Their source sternal marrow—which human not feasible. Additionally, collection more than 1 week limits practical elegant inducing provide thorough investigation macro- changes induced applying during CABG. results promising, further certainly needed make this applicable. Recovery surgeryThe Journal Thoracic Cardiovascular SurgeryVol. 162Issue 1PreviewThis aims (CABG) target myocardium; is, tissue persistently large animal model. Full-Text