Biomedical Engineering Reference
In-Depth Information
The self-renewal ability decreases per year with age, from 1% at
25 years to 0.45% at 75 years. The slow speed of cardiomyocyte
turnover dramatically increases after heart injury and begins from
endogenous cardiac stem cells. For these reasons cardiac stem cells
seems to be an interesting source for autologous transplantation.
3.3
Route of Administration
3.3.1
Systemic Intravenous Infusion
The injection of cells is performed through a catheter into a central
or peripheral vein. This technique is simple and less invasive than
other ways. However, the resulting cell survival and engraftment
are very low (< 1%) following cell transplantation. This method was
first used, but it is now replaced with systems improved for targeting
cells into the area of interest [49].
3.3.2
Intracoronary Cell Infusion
The cell suspension is injected through a balloon catheter into
the lumen of a coronary artery. Cell infusion is assisted by balloon
insufflations. Compared to intravenous delivery, this method has
an advantage that cells are injected directly into the myocardial
region. However, cell retention remains critical because cells have
to transmigrate across the endothelium. For example, this method
is useful during AMI when different chemotactic signals could drive
cells to injured tissue.
3.3.3
Intracardiac Injection
Intracardiac delivery is performed by three different methods: (a)
epicardial, (b) transendocardial, and (c) transvenous injections.
method, cells are delivered directly to
the area of interest by multiple injections. This technique needs to
be performed during cardiac surgery, because the heart should be
exposed as in the case of coronary artery bypass grafting. The major
advantage is that cells can be targeted in a specific area; nevertheless,
it is a very invasive procedure.
In the
epicardial injection
