OBJECTIVESTo determine the efficacy of combined use of transmyocardial stent with gene therapy to treat acute myocardial infarction in porcine model.

METHODS24 Chinese mini swines have been divided into 4 groups randomly: group myocardial infarction (group MI n(1) = 6), group transmyocardial stent (group ST n(2) = 6), group vascular endothelial growth factor (group VEGF n(3) = 6), group transmyocardial stent and VEGF (group ST + VEGF n(4) = 6). In group MI, acute myocardial infarction animal model has been established by the ligation of the left descending coronary artery. In group ST, after the establishment of the model, 3 transmyocardial stents were implanted. In group VEGF, an expression plasmid containing the gene-encoding VEGF(165) (300 microg) was administered directly in the myocardium at 6 sites. In group ST + VEGF, both transmyocardial stents and expression plasmid containing the gene-encoding VEGF(165) are applied. 4 weeks later, the animals are sacrificed and echocardiography and pathological analysis have been done.

RESULTSThe density of blood vessel in group ST, VEGF and ST + VEGF are significantly higher than group MI. And capillary density in group ST + VEGF is the highest in these groups statistically. Expression of VEGF was detected in group ST, VEGF and ST + VEGF, but in group VEGF and ST + VEGF the level of expression are higher.

CONCLUSIONCombined use of transmyocardial stent with gene therapy has synthetic effect for the treatment of acute myocardial ischemia in porcine model and can significantly increase the vascular density.