Robotic minimally invasive cell transplantation for heart failure

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Presentation transcript:

Robotic minimally invasive cell transplantation for heart failure Harald C. Ott, MD, Johannes Brechtken, MD, Cory Swingen, PhD, Tanya M. Feldberg, BS, Thomas S. Matthiesen, BS, Samuel A. Barnes, BS, Wendy Nelson, PhD, Doris A. Taylor, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 132, Issue 1, Pages 170-173 (July 2006) DOI: 10.1016/j.jtcvs.2006.02.017 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Schematic of robotic cell transplantation using the daVinci surgical robot. Swine are placed in the supine position and slightly rotated to the right, with elevated shoulders to expand the intercostal spaces. The camera port (a) is placed in the fifth, instrument ports (b) are placed in the third and seventh, and the auxiliary port is placed in the sixth (c) intercostal spaces. The 27-gauge winged injection needle (d) is inserted through the auxiliary port, allowing multiple tangential injections into the target area (shown in purple). B, Intrathoracic view of the injection device before and during intramyocardial injection. During injection, the rubber wings of the needle allow safe guidance but minimize the mechanical force applied to the left ventricular wall during slow injection. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 170-173DOI: (10.1016/j.jtcvs.2006.02.017) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Upper panels, Contrast-enhanced magnetic resonance cine images showing long-axis views of 2 cell-treated hearts. Cells are visible as signal voids (black dots) in the contrast-enhanced (shown in white) apical region (A) and the lateral wall (B) of the left ventricle (white arrows). LV, Left ventricle; LA, left atrium. Lower panels, Corresponding histologic sections of a cell-treated region at low and high magnification. C, Engrafted iron oxide–labeled myoblasts within the fibrotic infarction scar stain with Prussian blue (black arrows and arrowheads). D, Immunofluorescent staining for slow skeletal myosin (shown in green) shows the expression of skeletal muscle proteins in engrafted cells (white arrows and arrowheads), suggesting cell differentiation. Nuclei within the section are evidenced by fluorescent blue 4′,6-Diamidino-2-phenylindole (DAPI) staining. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 170-173DOI: (10.1016/j.jtcvs.2006.02.017) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions