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J Thorac Cardiovasc Surg 2001;121:835-836
© 2001 The American Association for Thoracic Surgery
Editorials |
From the Division of Cardiovascular Surgery, The Toronto Hospital, Toronto, Ontario, Canada.
Received for publication Feb 7, 2001. Accepted for publication Feb 9, 2001. Address for reprints: Richard D. Weisel, MD, FRCS, Division of Cardiovascular Surgery, The Toronto Hospital, 200 Elizabeth St, EN 14-215, Toronto M5G 2C4, Ontario, Canada (E-mail: Richard.Weisel@uhn.on.ca).
For related article, see p. 871.
The results of the first clinical experience with cell transplantation were reported to the American Heart Association in November 2000 by Menasche and associates
1 of Paris. A 72-year-old man who had a transmural myocardial infarction with an ejection fraction of 21% received skeletal myoblasts implanted into the infarct region at the time of coronary bypass surgery. Five months later, he had recovered from the operation, and perfusion and function of the infarct region had improved, perhaps related to the cell transplantation. This initial case report provides hope that the damage from an extensive myocardial infarction may be reversed. Coronary bypass surgery is frequently inadequate to restore function in patients who have few viable surviving myocytes in the infarct region. Cell transplantation offers the promise of restoring function in these unfortunate patients.
2-4 However, the era of cell transplantation has only begun. Major questions remain. What type of cell is appropriate for autotransplantation? When should these cells be delivered and by what route? What is the efficacy of cell transplantation relative to other medical and surgical treatments? What outcome
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