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Original Articles: Adult Cardiac

Targeted Myocardial Microinjections of a Biocomposite Material Reduces Infarct Expansion in Pigs

^a Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina
^b Abbott Vascular, Santa Clara, California

Accepted for publication April 29, 2008.

^_* Address correspondence to Dr Mukherjee, Cardiothoracic Surgery, 770 MUSC Complex, Suite 625, Medical University of South Carolina, Charleston, SC 29425 (Email: mukherr{at}musc.edu).

Presented at the Poster Session of the Forty-fourth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 28–30, 2008.

Background: Left ventricular (LV) remodeling after myocardial infarction (MI) commonly causes infarct expansion (IE). This study sought to interrupt IE through microinjections of a biocompatible composite material into the post-MI myocardium.

Methods: MI was created in 21 pigs (coronary ligation). Radiopaque markers (2-mm diameter) were placed for IE (fluoroscopy). Pigs were randomized for microinjections (25 injections; 2- x 2-cm array; 200 µL/injection) at 7 days post-MI of a fibrin-alginate composite (Fib-Alg; fibrinogen, fibronectin, factor XIII, gelatin-grafted alginate, thrombin; n = 11) or saline (n = 10).

Results: At 7 days after injection (14 days post-MI), LV posterior wall thickness was higher in the Fib-Alg group than in the saline group (1.07 ± 0.11 vs 0.69 ± 0.07 cm, respectively, p = 0.002). At 28 days post-MI, the area within the markers (IE) increased from baseline (1 cm²) in the saline (1.71 ± 0.13 cm², p = 0.010) and Fib-Alg groups (1.44 ± 0.23 cm², p < 0.001). However, the change in IE at 21 and 28 days post-MI was reduced in the Fib-Alg group (p=0.043 and p=0.019). Total collagen content within the MI region was similar in the saline and Fib-Alg groups (12.8 ± 1.7 and 11.6 ± 1.5 µg/mg, respectively, p = NS). However, extractable collagen, indicative of solubility, was lower in the Fib-Alg group than the saline group (59.1 ± 3.5 vs 71.0 ± 6.1 µg/mL, p = 0.020).

Conclusions: Targeted myocardial microinjection of the biocomposite attenuated the post-MI decrease in LV wall thickness and infarct expansion. Thus, intraoperative microinjections of biocompatible material may provide a novel approach for interrupting post-MI LV remodeling.

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				A. S. Cheng and T. Yau Invited Commentary Ann. Thorac. Surg., October 1, 2008; 86(4): 1276 - 1277. [Full Text] [PDF]