JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Shintaro Nemoto
Tadashi Ikeda
Masashi Komeda
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Takaba, K.
Right arrow Articles by Komeda, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Takaba, K.
Right arrow Articles by Komeda, M.
Related Collections
Right arrow Cardiac - physiology
Right arrow Coronary disease
Right arrow Molecular biology
Right arrowRelated Article

J Thorac Cardiovasc Surg 2006;132:891-899
© 2006 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

A combination of omental flap and growth factor therapy induces arteriogenesis and increases myocardial perfusion in chronic myocardial ischemia: Evolving concept of biologic coronary artery bypass grafting

Kiyoaki Takaba, MDa, Chunli Jiang, MDa, Shintaro Nemoto, MD, PhDa, Yoshiaki Saji, MDa, Tadashi Ikeda, MD, PhDa, Shinichi Urayama, MSb, Takashi Azuma, BSc, Akishige Hokugo, DDS, PhDc, Sadami Tsutsumi, PhDc, Yasuhiko Tabata, PhD, DMedSc, DPharmc, Masashi Komeda, MD, PhDa,*

a Department of Cardiovascular Surgery, Kyoto University, Graduate School of Medicine, Kyoto, Japan
b Human Brain Research Center, Kyoto University, Graduate School of Medicine, Kyoto, Japan
c Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.

Received for publication December 22, 2005; revisions received June 5, 2006; accepted for publication June 22, 2006.

* Address for reprints: Masashi Komeda, MD, PhD, Professor and Chairman, Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-machi, Sakyo-ku, Kyoto 606-8507, Japan. (Email: komelab{at}kuhp.kyoto-u.ac.jp).

Objective: The purpose of this study was to evaluate the therapeutic efficacy of the combined growth factor therapy with an omental flap in a rabbit model of chronic myocardial ischemia.

Methods: Chronic ischemia was created in rabbits by placing a constrictor on the left circumflex artery. Four weeks later the animals were divided into 3 groups: group FG, in which a gelatin hydrogel sheet incorporating 100 µg of basic fibroblast growth factor was placed over the left circumflex region followed by covering with the omental flap including the intact gastroepiploic artery; group F, in which only the basic fibroblast growth factor sheet was placed; and group N, in which no treatment was done.

Results: Cine magnetic resonance imaging analysis showed a greater percentage wall thickening in the left circumflex region in group FG than in other groups (group FG, 49.2% ± 4.5%; group F, 41.2% ± 3.8%; group N, 32.1% ± 2.5%, P =.035, group FG vs group F). A colored microsphere assay showed higher perfusion in the left circumflex region in group FG than in group F. Perfusion in the left circumflex region was decreased after clamping the gastroepiploic artery pedicle in group FG (before clamping, 2.83 ± 0.72 mL · min–1 · g–1; after clamping, 1.93 ± 0.59 mL · min–1 · g–1; P < .01). In vivo angiography via gastroepiploic artery showed direct "to-and-fro" visible collaterals between the gastroepiploic and occluded left circumflex coronary arteries in group FG.

Conclusion: The combined growth factor therapy with an omental flap induced arteriogenesis and provided additional perfusion via the gastroepiploic artery to ameliorate regional dysfunction in the chronically ischemic myocardium.

Abbreviations and Acronyms bFGF = basic fibroblast growth factor; FS = fractional shortening; GEA = gastroepiploic artery; LCx = left circumflex coronary artery; LV = left ventricular; LVEDD = left ventricular end-diastolic dimension; LVEF = left ventricular ejection fraction; LVESD = left ventricular end-systolic dimension; MRI = magnetic resonance imaging


Related Article

A combination of omental flap and growth factor therapy induces arteriogenesis and increases myocardial perfusion in chronic myocardial ischemia: Evolving concept of biologic coronary artery bypass grafting
Kiyoaki Takaba, Chunli Jiang, Shintaro Nemoto, Yoshiaki Saji, Tadashi Ikeda, Shinichi Urayama, Takashi Azuma, Akishige Hokugo, Sadami Tsutsumi, Yasuhiko Tabata, and Masashi Komeda
J. Thorac. Cardiovasc. Surg. 2006 132: 891-899. [Abstract] [Full Text] [PDF]





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2006 by The American Association for Thoracic Surgery.