Long Term Follow-Up of Coronary Sinus Delivery of Bone Marrow Cells for Congestive Heart Failure

Randomized studies suggest that intracoronary infusion of autologous cells improve heart function for patients with heart failure (HF). However, results have been mixed due to high cell loss and poor delivery. Coronary sinus delivery (CSD) of bone marrow cells holds promise for patients with HF. 77 patients were enrolled and completed 5 years follow up. Patients underwent SPECT evaluation; all had LVEF ≤ 25%, 40 patients with ischemic HF (IHF) and 37 patients with non-ischemic HF (nIHF). For IHF and nIHF at baseline: NYHA III/IV were 31/9 and 29/8 respectively; median LVEF were 18.7% and 24.7% respectively; median EDV were 281 ml and 242 ml respectively and median ESV were 217 ml and 189 ml respectively. Median numbers of MNC & CD34+ cells were 12*108 & 23*106 respectively. Cells were delivered in 90 cc via a coronary sinus approach using a balloon occlusion for 15 minutes. There were no adverse events related to the cell delivery. The results related to EF, NYHA, EDV, and ESV are shown below in the table Infusion of autologous bone marrow cells into the coronary sinus is safe and feasible. It is associated with significant improvement in symptoms and functional capacity benefit. Further randomized studies are warranted.