The People's Hospital of Beijing University performed a combined revascularization procedure utilizing beating heart bypass surgery, along with transmyocardial revascularization and stem cell implantation.
This is believed to be the first of such combination procedure. The patient is a 61 year old male suffering from chest pain related to an acute myocardial infarction. Angiography, as confirmed by SPECT, confirmed severe three vessel disease, with only the left internal mammary artery bypass from a previous surgical procedure still patent and perfusing the left anterior descending artery.
In preparation for the procedure, 5 ml of stem cells were derived from the patient's own bone marrow. Following the beating heart bypass through a left thoracotomy, TMR channeling (utilizing the Holmium: YAG laser system by CardioGenesis, Foothill Ranch, California, USA) was completed in all ischemic regions and the infarct zone. This was followed by injection of the stem cells in the same regions of the TMR channeling.
The attending cardiac surgeon, Dr. Wan Feng, Chairman of the Department of Cardiac Surgery at The People's Hospital of Beijing University, stated, "The objective of this procedure is to optimize the long term outcome of the patient. The bypass of the native coronary's will provide immediately improved perfusion to the ischemic areas. The TMR channels combined with autologous stem cells are intended to augment the bypass of the native coronary's with additional revascularization in the treated areas, including the infarct zone."
Dr. Wan has performed over 200 adjunctive TMR procedures to date. His belief that TMR promotes angiogenesis motivated him to apply the laser therapy with stem cells in the infarct area as well as the ischemic areas of the heart. "TMR by itself has been proven to promote angiogenesis in viable, ischemic heart muscle. By combining the laser with stem cells in the infarct zone, we are hopeful to contribute to the optimal outcome for this patient. Ultimately, we hope to see improved function in all areas of his heart, including the infarct area."
This procedure includes the application of several innovative technologies in the treatment of a challenging revascularization. The early outcome was favorable, with the patient in recovery with no arrhythmia. We look forward to further follow up of this innovative new combined treatment of advanced coronary artery disease. This combined procedure represents a first in China, and is worthy of a controlled, comparison study to identify the specific benefit of each of the techniques, and in combination.