In vitro thrombogenicity testing of pulsatile mechanical circulatory support systems: Design and proof-of-concept.
mechanical circulatory support
mock circulatory loop
porcine blood
pulsatile mechanical circulatory support
thromboelastometry
thrombogenicity
Journal
Artificial organs
ISSN: 1525-1594
Titre abrégé: Artif Organs
Pays: United States
ID NLM: 7802778
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
revised:
21
06
2021
received:
16
03
2021
accepted:
12
07
2021
pubmed:
28
7
2021
medline:
19
1
2022
entrez:
27
7
2021
Statut:
ppublish
Résumé
Thrombogenic complications are a main issue in mechanical circulatory support (MCS). There is no validated in vitro method available to quantitatively assess the thrombogenic performance of pulsatile MCS devices under realistic hemodynamic conditions. The aim of this study is to propose a method to evaluate the thrombogenic potential of new designs without the use of complex in-vivo trials. This study presents a novel in vitro method for reproducible thrombogenicity testing of pulsatile MCS systems using low molecular weight heparinized porcine blood. Blood parameters are continuously measured with full blood thromboelastometry (ROTEM; EXTEM, FIBTEM and a custom-made analysis HEPNATEM). Thrombus formation is optically observed after four hours of testing. The results of three experiments are presented each with two parallel loops. The area of thrombus formation inside the MCS device was reproducible. The implantation of a filter inside the loop catches embolizing thrombi without a measurable increase of platelet activation, allowing conclusions of the place of origin of thrombi inside the device. EXTEM and FIBTEM parameters such as clotting velocity (α) and maximum clot firmness (MCF) show a total decrease by around 6% with a characteristic kink after 180 minutes. HEPNATEM α and MCF rise within the first 180 minutes indicate a continuously increasing activation level of coagulation. After 180 minutes, the consumption of clotting factors prevails, resulting in a decrease of α and MCF. With the designed mock loop and the presented protocol we are able to identify thrombogenic hot spots inside a pulsatile pump and characterize their thrombogenic potential.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1513-1521Informations de copyright
© 2021 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation and Wiley Periodicals LLC.
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