JOHNSON CITY – A scientist from East Tennessee State University's James H. Quillen College of Medicine recently returned from China, where he instructed physicians on a new surgical procedure he devised for treating heart failure.
The technique, cellular cardiomyoplasty, was developed by Dr. Race L. Kao, holder of the Carroll H. Long Chair of Surgical Research at ETSU. While in China, he worked with cardiologists and cardiac surgeons at Nanjing Medical University, where three patients underwent the procedure in December. All three had an uneventful recovery.
According to Kao, cellular cardiomyoplasty is used for patients who have suffered a myocardial infarction, or heart attack. Here is how the procedure works. Doctors begin by removing a portion of muscle – approximately the size of a large acorn – from the patient's leg. A biopsy is performed and the satellite cells (myogenic stem cells) are isolated. During the next two to three weeks, the cells are harvested and cultured to produce a large supply. Afterwards, the patient undergoes surgery in which doctors take the cells and make 30-40 small injections to the injured heart muscle.
The result: these cells rejuvenate the damaged muscle.
“We basically are taking cells from one person's body and putting them on his or her heart,” Kao explained. “Because the satellite cells were taken from the patient's own leg, there will not be a problem with the body rejecting the treatment, as is often the case with transplantation when the donor heart is rejected.”
Kao emphasized that cellular cardiomyoplasty is not performed alone. Instead, it is done in conjunction with other standard cardiac surgical procedures, such as coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA).
“These procedures (CABG and PTCA) will restore blood flow and save the muscle cells that are dying,” Kao said. “But, cellular cardiomyoplasty goes beyond that by repairing those cells that are already dead.”
Kao published the first paper on the procedure in an August 1989 issue of The Physiologist. In 1997, his book, Cellular Cardiomyoplasty: Myocardial Repair with Cell Implantation, was released. Research using cellular cardiomyoplasty on animals continued around the world, and in June 2000, the first human trial took place in Paris, France.
Since then, cases have been performed in the United States at the University of California in Los Angeles and the Cleveland (Ohio) Clinic, and at sites in France, Holland, China and South America. All but one recovered uneventfully. That patient, one from Paris, required intensive drug and balloon support before undergoing CABG and developed intractable low cardiac output after surgery and later died.
Those who underwent cellular cardiomyoplasty reported to have improved heart function. Kao added that additional studies and long-term follow-up are necessary in order to determine the complete efficacy of this procedure.
For more information, contact Kao at (423) 439-8809.