55-year-old Ruth Pavelko lies in an operating suite that looks a bit like the mission control center for a rocket launch. In the darkened room, physicians and nurses gaze up intently at glowing monitors as interventional cardiologist Emerson Perin injects stem cells into Pavelko’s weakened heart.
Pavelko, who has diabetes, wasn’t even 50 when a blockage cut off blood to part of her heart muscle. By the time she was 55, she had suffered three more heart attacks, and despite 13 stents to prop open her arteries, the damage has caused her left ventricle to balloon in size.
Patients with extremely advanced heart failure may become eligible for an assistive device, an artificial heart, or a transplant. But a clinical trial at the Texas Heart Institute in Houston provided Pavelko with another option: injections of stem cells extracted from her own bone marrow. These progenitor cells can differentiate into a few types of cells, including those that form blood vessels.
Looking at the monitors the day of her operation, it is easy to see why Pavelko’s heart is failing. On one screen a fluoroscopy scan monitor, or moving X-ray, shows her heart’s lopsided pumping. Another monitor transmits a color-coded image Perin has created using electromechanical mapping technology that was originally devised to track missiles. Some of the heart muscle courses with blood, but other areas are deserts of dead tissue without blood vessels. The 3-D mapping technology allows Perin to determine in real time the viability of cardiac tissue and decide which areas are hospitable to stem cells. The distinction is vital; injecting stem cells into scar tissue could create more scar tissue.
