Retrograde coronary perfusion: a superior route to deliver therapeutics to the heart?*.

As the genomics and proteomics revolutions progress and the molecular biology of various cardiovascular pathologies is better understood, an increasing number of potential molecular therapies are being proposed. The ultimate success of any of these therapies depends upon many factors, including the biological activity of the therapeutic agents and the ability to deliver them to the proper cellular targets. Some of these agents may be effective when delivered systemically, whereas others may be safer and/or more effective when delivered locally. The use of drug-eluting stents to deliver anti-restenosis agents directly to targeted coronary segments is an excellent example of an effective “marriage” of a bioactive agent and an optimized local delivery strategy (1). In this issue of the Journal, von Degenfeld et al. (2) describe the use of an alternative delivery technique, retrograde coronary venous perfusion (RCVP), to deliver the angiogenic protein fibroblast growth factor-2 (FGF-2) to ischemic porcine hearts.