Peter Boekstegers And Christian Kupatt

Internal Medicine I, University Clinic of Grosshadern, Munich Germany

Abstract: Targeting the ischemic myocardium in the setting of coronary artery disease is usually hampered by the impaired arterial perfusion of the region of interest. Retroinfusion of the coronary veins has gained attention for therapeutic approaches which target drugs, genes or cells to ischemic myocardium. Besides anatomy of the coronary venous system, the pressure flow relationship during retroinfusion and the efficacy of pressure-regulated selective retroinfusion for targeted delivery of drugs is reported. Moreover, we describe adenoviral and liposomal gene transfer into ischemic and non-ischemic myocardium, outline studies in chronic ischemic preclinical models treated by retroinfusion of pro-angiogenic agents and discuss the impact of retroinfusion for cell-based regenerative therapy of the diseased myocardium

Keywords: Selective retroinfusion, pressure regulation, ischemia-reper-fusion, arteriogenesis, cell based therapy angiogenesis,

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