Swine experimental model to evaluate stem cells implant post myocardial infarction by perfusion gated-SPET.

Autologous bone marrow stromal cells (BMSC) implant after swine experimental myocardial infarct (MI) was investigated by serial technetium-99m ((99m)Tc)-tetrofosmin gated single photon emission tomography (G-SPET) and compared with immuno-histochemical findings. The aim was to evaluate if intramyocardial BMSC implant produces any prolonged effect in the left ventricle (LV) perfusion and function. Eleven pigs underwent left anterior descending artery (LAD) ligature; in seven of them BMSC were injected in the border zone of the MI, while in the remaining four saline solution was injected at the same site. After LAD ligature G-SPET scans at 48h and at 5 and 10 weeks (w) after the implant were performed. Uptake defect size and LV function analysis were performed comparing 48h to 5w and 10w studies. Statistical evaluation was performed with Friedman test and unpaired Wilcoxon test. The comparison between a progressive reduction of Perfusion Image Score was observed from 48h to 5w and to 10w in the treated group (Friedman test: χ²= 13.56; P=0.01). No variation was observed in the control group (Friedman test: χ²=3; P= 0.223). Comparison of the absolute variation (Δ) between treated and control group resulted significant (Wilcoxon test W=10; P=0.007). Similar positive results were also observed for the relative extension of the uptake defect, wall motion and LVEF analysis. Histological data of our swine model demonstrated that autologous BMSC implanted in the damaged myocardium area had survived and differentiated into cells with typical features of myocardiocytes. Gated SPET is a reliable tool to evaluate prolonged positive effects of autologous BMSC implant in swine experimental MI model. In conclusion, autologous BMSC implanted can improve perfusion, induce cell regeneration, reduce wall motion abnormalities and prevent severe LV dysfunction in swines.

Mesenteric ischemia in a patient with an acute aortic dissection type A. One-step repair of the aortic and visceral lesions. Role of laparoscopy for timely diagnosis and treatment.

Organ malperfusion is a serious complication of acute aortic dissection type A. Increased awareness of this complication and the availability of better diagnostic tools may improve the survival rate for these patients. Here, we discuss the potential role of laparoscopy in the setting of an acute dissecting aneurysm complicated by mesenteric ischemia.

Primary coronary embolism as an unusual manifestation of nonbacterial thrombotic endocarditis in a patient with gastric cancer.

Nonbacterial thrombotic endocarditis (NBTE) is a rare clinical condition characterized by the presence of sterile vegetations on valvular leaflets Gross and Friedberg (1936). The most frequent cause of NBTE is antiphospholipid syndrome Hughson and et al. (1993); malignancy, through an intrinsic condition of hypercoagulability, is the second most common cause Thomas (2001). Systemic thromboembolic complications are frequently associated with this condition, but coronary embolism is not common. We report the case of a patient with NBTE secondary to gastric adenocarcinoma with clinical symptoms of coronary and systemic emboli.