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J Thorac Cardiovasc Surg 2006;132:170-173
© 2006 The American Association for Thoracic Surgery

Brief Communication

Robotic minimally invasive cell transplantation for heart failure

Harald C. Ott, MD a , Johannes Brechtken, MD b , Cory Swingen, PhD c , Tanya M. Feldberg, BS a , Thomas S. Matthiesen, BS a , Samuel A. Barnes, BS a , Wendy Nelson, PhD a , Doris A. Taylor, PhD a , *

a Center for Cardiovascular Repair, University of Minnesota, Minneapolis, Minn
b Division of Cardiology, University of Minnesota, Minneapolis, Minn
c Department of Radiology, University of Minnesota, Minneapolis, Minn

Received for publication November 19, 2005; revisions received February 1, 2006; accepted for publication February 21, 2006.

* Address for reprints: Doris A. Taylor, PhD, Center for Cardiovascular Repair, University of Minnesota, 312 Church St SE, BSBE 7, Minneapolis, MN 55455. (Email: dataylor@umn.edu).

The first 20% of the full text of this article appears below.


Figure 1
Drs Swingen, Matthiesen, Nelson, Ott, Taylor, and Brechten (left to right)


Cardiac cell transplantation offers new opportunities as a potent therapeutic tool to improve left ventricular (LV) function and reverse postinfarction remodeling in ischemic heart disease. Skeletal myoblasts (SKMBs) engraft within infarcted myocardium, form myotubes, induce angiogenesis, and improve both diastolic and systolic LV function. 1 Go Bone marrow–derived mononuclear cells (BM-MNCs) likewise engraft, increase angiogenesis, and improve myocardial perfusion. 2 Go Both cell types have moved to clinical testing, and preclinical studies suggest that they could have synergistic functional benefits that argue for combined transplantation. 3,4 Go Intramyocardial injections are currently performed either percutaneously through an endoventricular or transvenous approach or surgically through a thoracotomy or sternotomy. We recently reported a video-assisted thoracoscopic technique to reduce invasiveness and perioperative risk of surgical cell delivery that was tested in uninjured swine hearts. 5 Go In the setting of heart failure (HF), mechanical manipulation of the left ventricle both by means of stabilization and cell injection must be minimized to prevent hemodynamic compromise, arrhythmia, and ventricular perforation. Robotically assisted cardiac surgery combines the advantages of minimal invasiveness and thoracoscopic access but adds a 3-dimensional view and 7 degrees of freedom that requires less cardiac manipulation than with the 2-dimensional view and limited freedom of motion of video-assisted thoracoscopic surgery. 6 Go We therefore propose a robot-assisted, beating-heart cell transplantation technique for use in severe HF to increase safety, optimize targeting, and reduce procedural time.

Procedure Description

Eleven injured swine in which HF was previously induced by means of coronary occlusion and coronary embolism (left anterior descending coronary artery, n = 9; circumflex . . . [Full Text of this Article]




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