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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1998 Dicembre;39(6):783-9

CARDIAC PAPERS 

 ORIGINAL ARTICLES

The stim­u­la­tion of neo­an­gio­gen­esis in the ­ischemic ­human ­heart by the ­growth ­factor FGF: first clin­ical ­results

Schumacher B., Stegmann Th.*, Pecher P.

From the Depart­ment of Cardiac Surgery, University of Ulm, Germany and the *Department of Thoracic and Car­di­o­vas­cular Sur­gery, Fulda Med­ical ­Center, ­Fulda, Ger­many

Back­ground. ­This ­paper is a ­report of our clin­ical expe­ri­ence ­with the ­human ­growth ­factor FGF as ­applied to the ­ischemic ­human myo­car­dium.
­Methods. ­After the com­ple­tion of exten­sive pre­lim­i­nary ­animal experi­ments, the ­growth ­factor FGF, ­obtained ­from genet­i­cally manip­u­lated E. ­coli bac­teria and ­highly pur­i­fied, was intro­duced ­into aor­to­cor­o­nary ­bypass sur­gery as an addi­tional ther­a­peutic ­agent. A ­double ­blind ­study was car­ried out on 40 ­patients ­with CHD, sep­ar­ated ­into “­growth ­factor” and con­trol ­groups, ­each con­taining 20 mem­bers. All the ­patients ­were ­treated for three­fold vas­cular dis­ease, in ­each ­case ­with an IMA ­bypass for the LAD and ­single ­venous ­bypasses for the RCX and/ or RCA. In ­order to ­bridge ­over addi­tional periph­eral ste­noses in the LAD or one of its ­branches, ­human ­growth ­factor FGF was ­injected ­into the myo­car­dium of ­those in the ­growth ­factor ­group. ­Twelve ­weeks ­later, the IMA ­bypasses ­were selec­tively dem­on­strated by intra­ar­te­rial DSA. ­These angio­graphs ­were ­then quan­ti­ta­tively eval­u­ated.
­Results. In all ­patients of the ­growth ­factor ­group, the for­ma­tion of new ves­sels ­could be dem­on­strated in the ­region ­where FGF had ­been admin­is­tered, in a ­manner ­strictly rem­i­nis­cent of our experi­mental ­results. A cap­il­lary net ­sprouting ­from the cor­o­nary ­artery and ­making fur­ther con­nec­tion ­with ­this ­vessel ­could be dem­on­strated, and the com­puter-sup­ported eval­u­a­tion of the angio­graphs ­showed a sig­nif­i­cant ­increase in the ­blood ­supply of the ­region of the myo­car­dium ­injected.
Con­clu­sions. It is there­fore our ­opinion ­that employ­ment of the ­human ­growth ­factor FGF rep­re­sents a ­useful exten­sion to ­bypass sur­gery, par­tic­u­larly for ­patients ­with an addi­tional periph­eral sten­osis ­that ­cannot be oper­a­tively revas­cu­lar­ized.

lingua: Inglese


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