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This investigational therapy, developed by Tehran University of Medical Sciences, is a combination biologic treatment consisting of mesenchymal stem cell (MSC)-derived exosomes and autologous mitochondria. It is designed for patients with severe heart failure (LVEF ≤ 25%) undergoing coronary artery bypass grafting (CABG). The MSC-derived exosomes, which are biological nanovesicles, are intended to limit inflammatory damage, while the fresh autologous mitochondria (extracted from the patient's pectoralis muscle) are used to limit oxidative stress and restore cellular energy. The treatment aims to protect the myocardium against ischemia-reperfusion injury, preserve cardiac function, and reduce the zone of myocardial infarction. In clinical application, exosomes are administered via the coronary sinus, and mitochondria are injected directly into ischemic myocardial tissue.
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