ASK THE CARDIO TEAM
Treating Chest Pain
When should a patient with chronic chest pain consider stem cell therapy?
>> DR. WARREN SHERMAN: Patients who have chest pain as a result of advanced coronary disease, generally have reasonable function of their heart muscle, but their angiograms, the arteries themselves are so severely blocked, have had multiple bypass surgeries and stents, and there’s nothing more to do. Those patients and they’re known as having refractory angina, chest pain that’s refractory to all medicines and other therapies, they are a significant population of patients that should be seriously considering stem cells. That’s one of the great opportunities for such patients.
>> DR. LESLIE MILLER: For those that have had demonstrated coronary disease, there’s been reported between 10% and 15%, we can’t get a catheter to the area that their heart is getting an inadequate delivery of oxygen. And so they have chest pain every day. They may have to take several nitroglycerin. It’s a really limiting kind of symptom and for which this may be ideal.
How can adult stem cell therapy help patients with chronic chest pain?
>> DR. NICOLAS CHRONOS: Patients with intractable angina, patients who are on standard of medical care with several antianginal medicines are really limited in their ability to do anything. They get this crushing chest pain. Many of those patients can’t have further stents, can’t have bypass surgery, are on all the medicines we’d expect. And the beauty of the stem cell approach is that it’s going to grow in these tiny little vessels into the areas of the heart muscle that lacks the blood supply, and therefore, potentially reduce the chest pain that the patient has.
What’s the procedure like for patients with chronic chest pain?
>> DR. MARC PENN: We deliver adipose-derived or stromal vascular fraction stem cells including mesenchymal stem cells and endothelial progenitor cells, also known as CD34-positive cells. Those cells are infused on the right side of the heart, the low-pressure side, through the coronary sinus, the major vein of the heart. We put a catheter up on the right side. We engage the coronary sinus. We infuse the stem cells into the coronary sinus for 10 minutes. At the end of the 10 minute time, we take our catheter out, and the procedure is complete.
What is the recovery like?
>> DR. SHERMAN: So, the recovery after receiving stem cells for chest pain is a matter of weeks, up to a week or two to recover from the incisions that are made to acquire the stem cells, the adipose stem cells, and then the heart, which hasn’t been damaged at all in the process, will recover immediately, and the improvement in symptoms start to appear within a matter of weeks to a small number of months.
What about retreatment for chest pain?
>> DR. PENN: In chronic chest pain patients, particularly those who respond to stem cell therapy whose chest pain starts to come back because, after all, the things that cause the chest pain—diabetes, cholesterol, things of that nature—are still present. If their chest pain were to return, they would be good candidates for retreatment for their chest pain.