TORONTO - When doctors performed a coronary artery bypass on a Montreal man with a failing heart, they added a little something else before closing up his chest -- stem cells purified from his bone marrow that they had removed earlier that day. The stem cells serve to regenerate blood vessels and heart muscle cells.
Jean-Paul Tremblay, a 59-year-old construction worker, is believed to be the first patient in Canada to have his heart injected with his own stem cells while having open-heart bypass surgery for chronic heart failure, said Dr. Nicolas Noiseux, a cardiac surgeon at Universite de Montreal.
No research team in the country had implemented such a complete treatment process, going from harvesting stem cells in the patient, treating them and injecting them directly into the myocardium (heart muscle), said Noiseux, co-principal investigator of a study on the experimental treatment.
The patient is doing remarkably well, because the day I did surgery his heart was so weak, and in fact it was a little bit scary, he said in an interview from Montreal.
And now ... it's just almost like a normal heart. This is an extraordinary case and hopefully we're going to have some great results on the next patient.
Scientists have great hopes for stem cells because they have the ability to turn into every single specialized cell that make up the human body. The human embryo is a plentiful source of stem cells. But as the body takes shape and matures, they become scarcer. However, bone marrow which constantly regenerates the blood supply and the immune system, remains a source of some stem cells.
The Montreal group plans to recruit 20 patients, with half receiving stem cells plus bypass and the other half getting a placebo injection plus the surgery. The two groups will then be compared to see what role, if any, the stem cells have played.
Researchers at Toronto General Hospital are joining the clinical trial, and are awaiting approval to conduct the research using a new-generation device to separate stem cells before beginning recruitment of their own 20 patients.
Cardiac surgeon Dr. Richard Weisel, director of the Toronto General Research Institute, said if the collaborative research shows the stem cells are regenerative, doctors would have a new tool to help patients facing end-stage heart failure.
Currently, these patients' best hope is a heart transplant. But donor hearts are in short supply and many patients die while on the transplant waiting list.
We want to give more to the heart failure patient, agreed Noiseux. But stem cells are probably not for everyone.
Hopefully we're going to show that this is safe, feasible and we can apply it to more patients. This is probably the key message that we want to give.