Abstract
BackgroundTemporary mechanical circulatory support device without sternotomy has been highly advocated for severe cardiogenic shock patient but little is known when coupled with amniotic stem cell therapy.Case presentationThis case reports the first dual therapy of temporary left ventricular extracorporeal device CentriMag with distal banding technique and human amniotic stem cell injection for treating a severe refractory cardiogenic shock of an 68-year-old female patient. A minimally-invasive off-pump LVAD was established by draining from the left ventricle and returning to the right axillary artery with distal arterial banding to prevent right upper extremity hyperperfusion. Amniotic stem cells were injected intramyocardially at the left ventricular apex, lateral wall, inferior wall, and right subclavian vein.ConclusionThe concomitant use of the temporary minimally-invasive off-pump CentriMag placement and stem cell therapy not only provided an alternative to cardiopulmonary bypass and full-median sternotomy procedures but may have also synergistically enhanced myocardial reperfusion and regeneration.
Highlights
Temporary mechanical circulatory support device without sternotomy has been highly advocated for severe cardiogenic shock patient but little is known when coupled with amniotic stem cell therapy.Case presentation: This case reports the first dual therapy of temporary left ventricular extracorporeal device CentriMag with distal banding technique and human amniotic stem cell injection for treating a severe refractory cardiogenic shock of an 68-year-old female patient
Severe refractory cardiogenic shock (RCS) can be defined as significant left or right ventricular dysfunction resulting in sustained hypotension and hypoperfusion of end-organs
The temporary left ventricular assist devices (VAD) implantation has been performed through median sternotomy with or without cardiopulmonary bypass (CPB) support
Summary
With regard to implantable LVAD, off pump placement has been reported [9]. to our best knowledge, this is the first dual therapy of using a temporary offpump implantation of a CentriMag as a left ventricular extracorporeal device with banding technique and human amniotic stem cell. CentriMag LVAD placement was performed in an off-pump fashion with left minithoracotomy and adjusted distal arm flow by placing a tourniquet This is a viable short-term solution as bridge to decision/recovery especially for patients with previous sternotomy. From the hemodynamic point of view, mechanically unloading the heart has been shown to increase survivability and promote differentiation of cardiac stem cells injected in the myocardium of an infarcted animal heart [11]; inhibit apoptotic mechanism and facilitated stem cells engraftment in a mouse model [12] It appears that our minimally invasive off pump approach minimizes sternotomy-induced myocardial inflammation, reduces myocardial load, improves coronary perfusion such that a favorable environment was created for amniotic stem cell to engraft and resurrect the ailing heart.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
