Research progress of preventing thrombosis in blood pump of ventricular assist devices_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LONG Dongping ¹ , XUE Jianrong ² , YUN Zhong ³

1. Intelligent Manufacturing Institute of Hunan University of Science and Technology, Xiangtan, 411201, Hunan, P.R.China;
2. School of Chemistry and Chemical Engineering, Hunan University of Science and Technology, Xiangtan, 411201, Hunan, P.R.China;
3. College of Mechanical and Electrical Engineering, Central South University, Changsha, 411083, P.R.China;

Corresponding author：

LONG Dongping, Email: ldp_1030@163.com

Keywords：

Blood pump; blood compatibility; thrombosis; anticoagulant; review

DOI：

10.7507/1007-4848.201912017

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Blood pump is the core component of artificial ventricular assist device, and thrombosis is a severe complication of blood pump in clinical application. Methods of controlling and reducing thrombosis include materials surface modification, structure and parameters optimization of blood pump, and others. The typical symptoms of thrombosis and the hazard of various types of blood pump, the formation mechanism and primary factors for thrombosis, and the simulation prediction models for thrombosis were reviewed in this paper.

Citation： LONG Dongping, XUE Jianrong, YUN Zhong. Research progress of preventing thrombosis in blood pump of ventricular assist devices. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(10): 1235-1241. doi: 10.7507/1007-4848.201912017 Copy

1.	Nazzari H, Chue CD, Toma M. Mechanical circulatory support in the heart failure population. Curr Opin Cardiol, 2019, 34(2): 194-201.
2.	Hetzer R, Kaufmann MEng F, Potapov E, <italic>et al</italic>. Rotary blood pumps as long-term mechanical circulatory support: A review of a 15-year Berlin experience. Semin Thorac Cardiovasc Surg, 2016, 28(1): 12-23.
3.	张岩, 孙寒松, 胡盛寿. 左心室辅助血泵及其临床应用研究进展. 中国胸心血管外科临床杂志, 2017, 24(2): 152-155.
4.	Chen Z, Zhang J, Kareem K, <italic>et al</italic>. Device-induced platelet dysfunction in mechanically assisted circulation increases the risks of thrombosis and bleeding. Artif Organs, 2019, 43(8): 745-755.
5.	Kittipibul V, Xanthopoulos A, Hurst TE, <italic>et al</italic>. Clinical courses of HeartMateⅡleft ventricular assist device thrombosis. ASAIO J, 2020, 66(2): 153-159.
6.	Selzman CH, Koliopoulou A, Glotzbach JP, <italic>et al</italic>. Evolutionary improvements in the Jarvik 2000 left ventricular assist device. ASAIO J, 2018, 64(6): 827-830.
7.	Dang G, Epperla N, Mupiddi V, <italic>et al</italic>. Medical management of pump related thrombosis in patients with continuous flow left ventricular assist devices: a systematic review and meta-analysis. ASAIO J, 2017, 63(4): 373-385.
8.	Koliopoulou A, McKellar SH, Rondina M, <italic>et al</italic>. Bleeding and thrombosis in chronic VAD therapy: focus on platelets. Curr Opin Cardiol, 2016, 31(3): 299-307.
9.	Morici N, Varrenti M, Brunelli D, <italic>et al</italic>. Antithrombotic therapy in ventricular assist device (VAD) management: From ancient beliefs to updated evidence. A narrative review. Int J Cardiol Heart Vasc, 2018, 20: 20-26.
10.	Kapur NK, Vest AR, Cook J, <italic>et al</italic>. Pump thrombosis: A limitation of contemporary left ventricular assist devices. Curr Probl Cardiol, 2015, 40(12): 511-540.
11.	Uriel N, Han J, Morrison KA, <italic>et al</italic>. Device thrombosis in HeartMateⅡcontinuous-flow left ventricular assist devices: A multifactorial phenomenon. J Heart Lung Transplant, 2014, 33(1): 51-59.
12.	余佳佳. 基于溶凝血分析的轴流血泵转子外形优化设计. 清华大学, 2016.
13.	吴广辉, 蔺嫦燕, 侯晓彤, 等. 绵羊植入左心室辅助装置在体实验手术管理. 首都医科大学学报, 2015, 36(2): 291-298.
14.	Grover SP, Mackman N. Tissue factor: An essential mediator of hemostasis and trigger of thrombosis. Arterioscler Thromb Vasc Biol, 2018, 38(4): 709-725.
15.	Gorbet M, Sperling C, Maitz MF, <italic>et al</italic>. The blood compatibility challenge. Part 3: Material associated activation of blood cascades and cells. Acta Biomater, 2019, 94: 25-32.
16.	Gorbet MB, Sefton MV. Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. Biomaterials, 2004, 25(26): 5681-5703.
17.	Spanier T, Oz M, Levin H, <italic>et al</italic>. Activation of coagulation and fibrinolytic pathways in patients with left ventricular assist devices. J Thorac Cardiovasc Surg, 1996, 112(4): 1090-1097.
18.	Mehrabadi M, Ku DN, Champion JA, et al. Effects of red blood cells and shear rate on thrombus growth. Georgia Institute of Technology, 2014.
19.	侯丽, 乔春霞, 赵增琳. 解读ISO 10993-4:2017《医疗器械生物学评价第4部分:与血液相互作用试验选择》. 中国医疗设备, 2018, 33(11): 1-6.
20.	Maruyama O, Numata Y, Nishida M, <italic>et al</italic>. Hemolysis caused by surface roughness under shear flow. J Artif Organs, 2005, 8(4): 228-236.
21.	方媛. 心脏泵流道内表面加工形貌对血液兼容性影响的研究. 哈尔滨理工大学, 2018.
22.	Jokinen V, Kankuri E, Hoshian S, <italic>et al</italic>. Superhydrophobic blood-repellent surfaces. Adv Mater, 2018, 30(24): e1705104.
23.	李卫东. 离心式人工心脏泵血流动力学特性分析与优化研究. 哈尔滨工业大学, 2016.
24.	李驰培, 杨秀萍, 陈俊, 等. 轴流血泵流场分析与结构改进. 制造业自动化, 2018, 40(11): 49-52.
25.	Mehra MR, Stewart GC, Uber PA. The vexing problem of thrombosis in long-term mechanical circulatory support. J Heart Lung Transplant, 2014, 33(1): 1-11.
26.	Bouchnita A, Volpert V. A multiscale model of platelet-fibrin thrombus growth in the flow. Comput Fluids, 2019, 184: 10-20.
27.	Yazdani A, Li H, Humphrey JD, <italic>et al</italic>. A General shear-dependent model for thrombus formation. PLoS Comput Biol, 2017, 13(1): e1005291.
28.	Leiderman K, Fogelson A. An overview of mathematical modeling of thrombus formation under flow. Thromb Res, 2014, 133(Suppl 1): S12-S14.
29.	Giersiepen M, Wurzinger LJ, Opitz R, <italic>et al</italic>. Estimation of shear stress-related blood damage in heart valve prostheses--in vitro comparison of 25 aortic valves. Int J Artif Organs, 1990, 13(5): 300-306.
30.	Boreda R, Fatemi RS, Rittgers SE. Potential for platelet stimulation in critically stenosed carotid and coronary arteries. J Vasc Invest, 1995, 1: 26-37.
31.	Faghih MM, Sharp MK. Extending the power-law hemolysis model to complex flows. J Biomech Eng, 2016, 138(12): 10.1115/1.4034786.
32.	Sheriff J, Soares JS, Xenos M, <italic>et al</italic>. Evaluation of shear-induced platelet activation models under constant and dynamic shear stress loading conditions relevant to devices. Ann Biomed Eng, 2013, 41(6): 1279-1296.
33.	Hosseinzadegan H, Tafti DK. Modeling thrombus formation and growth. Biotechnol Bioeng, 2017, 114(10): 2154-2172.
34.	Sorensen EN, Burgreen GW, Wagner WR, <italic>et al</italic>. Computational simulation of platelet deposition and activation:Ⅰ. Model development and properties. Ann Biomed Eng, 1999, 27(4): 436-448.
35.	Sorensen EN, Burgreen GW, Wagner WR, <italic>et al</italic>. Computational simulation of platelet deposition and activation:Ⅱ. Results for Poiseuille flow over collagen. Ann Biomed Eng, 1999, 27(4): 449-458.
36.	Taylor JO, Yang L, Deutsch S, <italic>et al</italic>. Development of a platelet adhesion transport equation for a computational thrombosis model. J Biomech, 2017, 50: 114-120.
37.	Jamiolkowski MA, Woolley JR, Kameneva MV, <italic>et al</italic>. Real time visualization and characterization of platelet deposition under flow onto clinically relevant opaque surfaces. J Biomed Mater Res A, 2015, 103(4): 1303-1311.
38.	Wu WT, Jamiolkowski MA, Wagner WR, <italic>et al</italic>. Multi-constituent simulation of thrombus deposition. Sci Rep, 2017, 7: 42720.
39.	Lee S, Cho Y, Kang S, <italic>et al</italic>. Evaluation of an extended viscoelastic model to predict hemolysis in cannulas and blood pumps. J Mech Sci Tec, 2019, 33(5): 2181-2188.
40.	Topper SR, Navitsky MA, Medvitz RB, et al. The use of fluid mechanics to predict regions of microscopic thrombus formation in pulsatile VADs. Cardiovasc Eng Technol, 2014, 5(1):54-69.
41.	Sin DC, Kei HL, Miao X. Surface coatings for ventricular assist devices. Expert Rev Med Device, 2009, 6(1): 51-60.
42.	Kustosz R, Altyntsev I, Darlak M, <italic>et al</italic>. The TiN coatings utilisation as blood contact surface modification in implantable rotary left ventricle assist device Religaheart Rot. Arch Metal Mater, 2015, 60(3): 2253-2260.
43.	Zeng H, Jarvik R, Catausan G, <italic>et al</italic>. Diamond coated artificial cardiovascular devices. Surf Coat Technol, 2016, 302: 420-425.
44.	Werkkala K, Jokinen JJ, Soininen L, <italic>et al</italic>. Clinical durability of the CARMEDA BioActive surface in EXCOR ventricular assist device pumps. ASAIO J, 2016, 62(2): 139-142.
45.	Biran R, Pond D. Heparin coatings for improving blood compatibility of medical devices. Adv Drug Deliv Rev, 2017, 112: 12-23.
46.	Chen L, Han D, Jiang L. On improving blood compatibility: from bioinspired to synthetic design and fabrication of biointerfacial topography at micro/nano scales. Colloids Surf B Biointerfaces, 2011, 85(1): 2-7.
47.	Xiang L, Li J, He Z, <italic>et al</italic>. Design and construction of TiO<sub>2</sub> nanotubes in microarray using two-step anodic oxidation for application of cardiovascular implanted devices. Micro Nano Lett, 2015, 10(6): 287-291.
48.	Karaman O, Kelebek S, Demirci EA, <italic>et al</italic>. Synergistic effect of cold plasma treatment and RGD peptide coating on cell proliferation over titanium surfaces. Tissue Eng Regen Med, 2017, 15(1): 13-24.
49.	Li G, Yang P, Liao Y, <italic>et al</italic>. Tailoring of the titanium surface by immobilization of heparin/fibronectin complexes for improving blood compatibility and endothelialization: an in vitro study. Biomacromolecules, 2011, 12(4): 1155-1168.
50.	Thamsen B, Mevert R, Lommel M, <italic>et al</italic>. A two-stage rotary blood pump design with potentially lower blood trauma: a computational study. Int J Artif Organs, 2016, 39(4): 178-183.
51.	周冰晶, 张桂杰, 荆腾, 等. 心衰脉动过程两级轴流血泵溶血数值模拟. 排灌机械工程学报, 2018, 36(1): 28-34.
52.	陈彬彬, 曹中清, 何林峰. 轴流血泵的数值仿真与结构改进. 机床与液压, 2017, 45(17): 171-175.

1. Nazzari H, Chue CD, Toma M. Mechanical circulatory support in the heart failure population. Curr Opin Cardiol, 2019, 34(2): 194-201.
2. Hetzer R, Kaufmann MEng F, Potapov E, <italic>et al</italic>. Rotary blood pumps as long-term mechanical circulatory support: A review of a 15-year Berlin experience. Semin Thorac Cardiovasc Surg, 2016, 28(1): 12-23.
3. 张岩, 孙寒松, 胡盛寿. 左心室辅助血泵及其临床应用研究进展. 中国胸心血管外科临床杂志, 2017, 24(2): 152-155.
4. Chen Z, Zhang J, Kareem K, <italic>et al</italic>. Device-induced platelet dysfunction in mechanically assisted circulation increases the risks of thrombosis and bleeding. Artif Organs, 2019, 43(8): 745-755.
5. Kittipibul V, Xanthopoulos A, Hurst TE, <italic>et al</italic>. Clinical courses of HeartMateⅡleft ventricular assist device thrombosis. ASAIO J, 2020, 66(2): 153-159.
6. Selzman CH, Koliopoulou A, Glotzbach JP, <italic>et al</italic>. Evolutionary improvements in the Jarvik 2000 left ventricular assist device. ASAIO J, 2018, 64(6): 827-830.
7. Dang G, Epperla N, Mupiddi V, <italic>et al</italic>. Medical management of pump related thrombosis in patients with continuous flow left ventricular assist devices: a systematic review and meta-analysis. ASAIO J, 2017, 63(4): 373-385.
8. Koliopoulou A, McKellar SH, Rondina M, <italic>et al</italic>. Bleeding and thrombosis in chronic VAD therapy: focus on platelets. Curr Opin Cardiol, 2016, 31(3): 299-307.
9. Morici N, Varrenti M, Brunelli D, <italic>et al</italic>. Antithrombotic therapy in ventricular assist device (VAD) management: From ancient beliefs to updated evidence. A narrative review. Int J Cardiol Heart Vasc, 2018, 20: 20-26.
10. Kapur NK, Vest AR, Cook J, <italic>et al</italic>. Pump thrombosis: A limitation of contemporary left ventricular assist devices. Curr Probl Cardiol, 2015, 40(12): 511-540.
11. Uriel N, Han J, Morrison KA, <italic>et al</italic>. Device thrombosis in HeartMateⅡcontinuous-flow left ventricular assist devices: A multifactorial phenomenon. J Heart Lung Transplant, 2014, 33(1): 51-59.
12. 余佳佳. 基于溶凝血分析的轴流血泵转子外形优化设计. 清华大学, 2016.
13. 吴广辉, 蔺嫦燕, 侯晓彤, 等. 绵羊植入左心室辅助装置在体实验手术管理. 首都医科大学学报, 2015, 36(2): 291-298.
14. Grover SP, Mackman N. Tissue factor: An essential mediator of hemostasis and trigger of thrombosis. Arterioscler Thromb Vasc Biol, 2018, 38(4): 709-725.
15. Gorbet M, Sperling C, Maitz MF, <italic>et al</italic>. The blood compatibility challenge. Part 3: Material associated activation of blood cascades and cells. Acta Biomater, 2019, 94: 25-32.
16. Gorbet MB, Sefton MV. Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. Biomaterials, 2004, 25(26): 5681-5703.
17. Spanier T, Oz M, Levin H, <italic>et al</italic>. Activation of coagulation and fibrinolytic pathways in patients with left ventricular assist devices. J Thorac Cardiovasc Surg, 1996, 112(4): 1090-1097.
18. Mehrabadi M, Ku DN, Champion JA, et al. Effects of red blood cells and shear rate on thrombus growth. Georgia Institute of Technology, 2014.
19. 侯丽, 乔春霞, 赵增琳. 解读ISO 10993-4:2017《医疗器械生物学评价第4部分:与血液相互作用试验选择》. 中国医疗设备, 2018, 33(11): 1-6.
20. Maruyama O, Numata Y, Nishida M, <italic>et al</italic>. Hemolysis caused by surface roughness under shear flow. J Artif Organs, 2005, 8(4): 228-236.
21. 方媛. 心脏泵流道内表面加工形貌对血液兼容性影响的研究. 哈尔滨理工大学, 2018.
22. Jokinen V, Kankuri E, Hoshian S, <italic>et al</italic>. Superhydrophobic blood-repellent surfaces. Adv Mater, 2018, 30(24): e1705104.
23. 李卫东. 离心式人工心脏泵血流动力学特性分析与优化研究. 哈尔滨工业大学, 2016.
24. 李驰培, 杨秀萍, 陈俊, 等. 轴流血泵流场分析与结构改进. 制造业自动化, 2018, 40(11): 49-52.
25. Mehra MR, Stewart GC, Uber PA. The vexing problem of thrombosis in long-term mechanical circulatory support. J Heart Lung Transplant, 2014, 33(1): 1-11.
26. Bouchnita A, Volpert V. A multiscale model of platelet-fibrin thrombus growth in the flow. Comput Fluids, 2019, 184: 10-20.
27. Yazdani A, Li H, Humphrey JD, <italic>et al</italic>. A General shear-dependent model for thrombus formation. PLoS Comput Biol, 2017, 13(1): e1005291.
28. Leiderman K, Fogelson A. An overview of mathematical modeling of thrombus formation under flow. Thromb Res, 2014, 133(Suppl 1): S12-S14.
29. Giersiepen M, Wurzinger LJ, Opitz R, <italic>et al</italic>. Estimation of shear stress-related blood damage in heart valve prostheses--in vitro comparison of 25 aortic valves. Int J Artif Organs, 1990, 13(5): 300-306.
30. Boreda R, Fatemi RS, Rittgers SE. Potential for platelet stimulation in critically stenosed carotid and coronary arteries. J Vasc Invest, 1995, 1: 26-37.
31. Faghih MM, Sharp MK. Extending the power-law hemolysis model to complex flows. J Biomech Eng, 2016, 138(12): 10.1115/1.4034786.
32. Sheriff J, Soares JS, Xenos M, <italic>et al</italic>. Evaluation of shear-induced platelet activation models under constant and dynamic shear stress loading conditions relevant to devices. Ann Biomed Eng, 2013, 41(6): 1279-1296.
33. Hosseinzadegan H, Tafti DK. Modeling thrombus formation and growth. Biotechnol Bioeng, 2017, 114(10): 2154-2172.
34. Sorensen EN, Burgreen GW, Wagner WR, <italic>et al</italic>. Computational simulation of platelet deposition and activation:Ⅰ. Model development and properties. Ann Biomed Eng, 1999, 27(4): 436-448.
35. Sorensen EN, Burgreen GW, Wagner WR, <italic>et al</italic>. Computational simulation of platelet deposition and activation:Ⅱ. Results for Poiseuille flow over collagen. Ann Biomed Eng, 1999, 27(4): 449-458.
36. Taylor JO, Yang L, Deutsch S, <italic>et al</italic>. Development of a platelet adhesion transport equation for a computational thrombosis model. J Biomech, 2017, 50: 114-120.
37. Jamiolkowski MA, Woolley JR, Kameneva MV, <italic>et al</italic>. Real time visualization and characterization of platelet deposition under flow onto clinically relevant opaque surfaces. J Biomed Mater Res A, 2015, 103(4): 1303-1311.
38. Wu WT, Jamiolkowski MA, Wagner WR, <italic>et al</italic>. Multi-constituent simulation of thrombus deposition. Sci Rep, 2017, 7: 42720.
39. Lee S, Cho Y, Kang S, <italic>et al</italic>. Evaluation of an extended viscoelastic model to predict hemolysis in cannulas and blood pumps. J Mech Sci Tec, 2019, 33(5): 2181-2188.
40. Topper SR, Navitsky MA, Medvitz RB, et al. The use of fluid mechanics to predict regions of microscopic thrombus formation in pulsatile VADs. Cardiovasc Eng Technol, 2014, 5(1):54-69.
41. Sin DC, Kei HL, Miao X. Surface coatings for ventricular assist devices. Expert Rev Med Device, 2009, 6(1): 51-60.
42. Kustosz R, Altyntsev I, Darlak M, <italic>et al</italic>. The TiN coatings utilisation as blood contact surface modification in implantable rotary left ventricle assist device Religaheart Rot. Arch Metal Mater, 2015, 60(3): 2253-2260.
43. Zeng H, Jarvik R, Catausan G, <italic>et al</italic>. Diamond coated artificial cardiovascular devices. Surf Coat Technol, 2016, 302: 420-425.
44. Werkkala K, Jokinen JJ, Soininen L, <italic>et al</italic>. Clinical durability of the CARMEDA BioActive surface in EXCOR ventricular assist device pumps. ASAIO J, 2016, 62(2): 139-142.
45. Biran R, Pond D. Heparin coatings for improving blood compatibility of medical devices. Adv Drug Deliv Rev, 2017, 112: 12-23.
46. Chen L, Han D, Jiang L. On improving blood compatibility: from bioinspired to synthetic design and fabrication of biointerfacial topography at micro/nano scales. Colloids Surf B Biointerfaces, 2011, 85(1): 2-7.
47. Xiang L, Li J, He Z, <italic>et al</italic>. Design and construction of TiO<sub>2</sub> nanotubes in microarray using two-step anodic oxidation for application of cardiovascular implanted devices. Micro Nano Lett, 2015, 10(6): 287-291.
48. Karaman O, Kelebek S, Demirci EA, <italic>et al</italic>. Synergistic effect of cold plasma treatment and RGD peptide coating on cell proliferation over titanium surfaces. Tissue Eng Regen Med, 2017, 15(1): 13-24.
49. Li G, Yang P, Liao Y, <italic>et al</italic>. Tailoring of the titanium surface by immobilization of heparin/fibronectin complexes for improving blood compatibility and endothelialization: an in vitro study. Biomacromolecules, 2011, 12(4): 1155-1168.
50. Thamsen B, Mevert R, Lommel M, <italic>et al</italic>. A two-stage rotary blood pump design with potentially lower blood trauma: a computational study. Int J Artif Organs, 2016, 39(4): 178-183.
51. 周冰晶, 张桂杰, 荆腾, 等. 心衰脉动过程两级轴流血泵溶血数值模拟. 排灌机械工程学报, 2018, 36(1): 28-34.
52. 陈彬彬, 曹中清, 何林峰. 轴流血泵的数值仿真与结构改进. 机床与液压, 2017, 45(17): 171-175.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research progress of preventing thrombosis in blood pump of ventricular assist devices

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content