Use of left atrial appendage as an autologous tissue source for epicardial micrograft transplantation during LVAD implantation

Front Cardiovasc Med. 2023 Apr 28:10:1143886. doi: 10.3389/fcvm.2023.1143886. eCollection 2023.

Abstract

We report here the first clinical use of the left atrial appendage (LAA) for epicardial micrograft transplantation during left ventricular assist device (LVAD) implantation. Previously, a sample from the right atrial appendage (RAA) has been available for processing and administering micrograft therapy in cardiac surgery. Both LAA and RAA are rich sources of various types of myocardial cells and are capable of providing both paracrine and cellular support to the failing myocardium. The surgical approach of LAA micrografting facilitates epicardial micrograft therapy dose escalation and treatment of larger myocardial areas than done previously. Moreover, as collection of treated vs. untreated tissues from the recipient heart is possible following LVAD implantation at the time of heart transplantation, the evaluation of the therapy's mechanism of action can be further deciphered at cellular and molecular levels. This LAA modification of the epicardial micrografting technique has the overall potential to facilitate the adoption of cardiac cell therapy during heart surgery.

Keywords: autologous cardiac micrografts; cell therapy; epicardial transplantation; heart failure; left atrial appendage (LAA); left ventricular assist device (LVAD).

Grants and funding

EpiHeart Oy and HBW srl contributed materials to this study. Open access funding was received from EpiHeart Oy. EpiHeart Oy were not involved in the study design, collection, analysis, interpretation of data, the writing of the article or the decision to submit it for publication.