RESUMO
Study aim - to elucidate possibilities of the use of precision administration of mononuclear bone marrow cells (MBMC) for the treatment of myocardial ischemia and heart failure. "Intramyocardial Multiple Precision Administration of Mononuclear Bone Marrow Cells in the Treatment of Myocardial Ischemia" was a double blind randomized placebo controlled study in which we included patients more or equal 6 months after Q-wave myocardial infarction with systolic myocardial dysfunction (ejection fraction <35%), not requiring myocardial revascularization, receiving stable optimal medical therapy for more or equal 8 weeks, and with implanted cardioverter-defibrillator. Transplantation of MBMC was guided by fluoroscopy and tridimensional NOGA XP Cardiac Navigation System. For assessment of efficacy of the method we used surrogate end points: decrease of number of fixed perfusion defects according to SPECT data and improvement of regional myocardial contractility according to data of echocardiography. Results of dynamic observation of the first experience of MBMC administration are presented in this paper.
Assuntos
Transplante de Medula Óssea/métodos , Insuficiência Cardíaca , Infarto do Miocárdio/complicações , Isquemia Miocárdica , Adulto , Fármacos Cardiovasculares/uso terapêutico , Método Duplo-Cego , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/terapia , Testes de Função Cardíaca/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Contração Miocárdica , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/terapia , Radiografia Intervencionista/métodos , Terapia Assistida por Computador/métodos , Tomografia Computadorizada de Emissão de Fóton Único , Resultado do TratamentoRESUMO
The paper presents the results of anterior spine fusion in 250 patients with tuberculous spondylitis involving 2 to 8 vertebrae, by using free and non-free autologous bone grafts, carbonaceous implants, and revascularized transplants. Anterior spine fusion added to posterior spinal fixation with a CD-type metal construction. A tuberculous process in the spine was cured in 96.1% of cases; the spinal support capability recovery rate was 95.2% in the early postoperative period and in 93.5% in the late one.