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Updated: Jun 8, 2026
Isolation of Perivascular Multipotent Precursor Cell Populations from Human Cardiac Tissue
Published on: October 8, 2016
Intrapericardial procedures for cardiac regeneration by stem cells: need for minimal invasive access (AttachLifter)
1Department of Internal Medicine - Cardiology, Experimental Cardiology Laboratory, Philipps University of Marburg, Marburg, Deutschland. rupp@staff.uni-marburg.de
Insights
Intrapericardial delivery of stem cells may enhance cardiac regeneration more effectively than traditional methods. Novel tools facilitate access to the pericardial space for improved stem cell therapy in heart disease.
Area of Science:
- Regenerative Medicine
- Cardiology
- Biomedical Engineering
Background:
- Current bone marrow-derived cell transplantation offers modest improvements for heart disease.
- Existing delivery routes (intracoronary, transcoronary-venous, intramyocardial) may be suboptimal for cardiac regeneration.
Purpose of the Study:
- To investigate the potential of intrapericardial delivery of stem cells or cardiac stem cell activators for enhanced therapeutic benefits.
- To describe novel tools for accessing the pericardial space, even without effusion, for improved cell delivery.
Main Methods:
- Development of novel tools for pericardial access, including the "AttachLifter" and "Attacher" mechanisms.
- Utilizing a suction head with flexible clamps and "needle guidance" to safely puncture the pericardium.
- Employing a fiberscope for pre-puncture inspection of the pericardium.
Main Results:
- The described tools enable access to the pericardial space for potential stem cell or factor delivery.
- Sustained kinetics of cell or factor delivery to the myocardium from an intrapericardial depot is hypothesized.
- The study lays the groundwork for assessing the role of the pericardial space in cardiac regeneration.
Conclusions:
- Intrapericardial delivery presents a promising strategy to potentially improve cardiac regeneration compared to current methods.
- Novel instrumentation facilitates safe and effective access to the pericardial space for therapeutic interventions.
- Further research can now explore the functional impact of intrapericardial delivery in cardiac repair.
Abstract:
In view of the only modest functional and anatomical improvements achieved by bone marrow-derived cell transplantation in patients with heart disease, the question was addressed whether the intracoronary, transcoronary-venous, and intramyocardial delivery routes are adequate. It is hypothesized that an intrapericardial delivery of stem cells or activators of resident cardiac stem cells increases therapeutic benefits. From such an intrapericardial depot, cells or modulating factors, such as thymosin β4 or Ac-SDKP, are expected to reach the myocardium with sustained kinetics. Novel tools which provide access to the pericardial space even in the absence of pericardial effusion are, therefore, described. When the pericardium becomes attached to the suction head (monitored by an increase in negative pressure), the pericardium is lifted from the epicardium ("AttachLifter"). The opening of the suction head ("Attacher") is narrowed by flexible clamps which grab the tissue and improve the vacuum seal in the case of uneven tissue. A ridge, i.e.,"needle guidance", on the suction head excludes injury to the epicardium, whereby the pericardium is punctured by a needle which resides outside the suction head. A fiberscope can be used to inspect the pericardium prior to puncture. Based on these procedures, the role of the pericardial space and the presence of pericardial effusion in cardiac regeneration can be assessed.
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