Analysis of perioperative complication during treating acute myocardial infarction by autologous bone marrow stem cell transplantation

Aim: To analyze the perioperative complications for the treatment of acute myocardial infarction (AMI) by autologous bone marrow stem cell transplantation. Methods: Forty AMI patients, who were treated by autologous bone marrow mononuclear cell transplantation, standard medication and percutaneous coronary intervention in Tangshan Worker's Hospital between September 2004 and December 2006, were selected in this study. All of the treatments were approved by the Hospital Ethics Committee and all of the patients knew the facts saying yes. All patients were treated by standard medication according to the clinical needs before and after operation. Bone marrow was drawn off by puncturing at two side of posterior superior iliac spine, and then fat particles and bone chippings were filtrated. The total amount of bone marrow collecting was 100-120 mL. Bone marrow mononuclear cell suspension of 12-15 mL was got by density gradient centrifugalization, which should be preserved within 4 hours at room temperature. After bilateral coronary artery angiograghy and frame transplantation into left anterior descending branch, guide wire was placed the distant end of sick area, and 'over the wire' balloon was put into the frame along the guide wire. Then the bone marrow mononuclear cell suspension was injected into into the distant end of AMI-related vessels, which were infracted through the central cavity of the 'over the wire' balloon. The amount of injection was 4.0-5.0 mL for each time. With the intermission of 2 minutes after the balloon was vacuated, the cell suspension was injected by the same method. This process was repeated 3 times. Results: All of 40 AMI cases undergoing autologous bone marrow mononuclear cell transplantation were analyzed in the result. There were 34 various perioperative complications and the incidence was as follows: blood vessel complication 20%; chest ache 17.5%; arrhythmia 15%; hypotension 12.5%; cardiac insufficiency 10%; vagus reflex 7.5%; hypoglycemia 2.5%. Conclusion: Along with the development and the operative technique standardization of coronary artery intervention therapy, the successful rate of operation is gradually increasing. But there are still some complications and sudden events that occur in perioperative period, which suggest that observing the states of illness rigorously, adopting prevention measures and proper lash-up treatment pertinently can reduce the risk of stem cell transplantations.