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Thrombus generation within the artificial heart.

D B Olsen, F Unger, H Oster

    The Journal of Thoracic and Cardiovascular Surgery
    |August 1, 1975
    PubMed
    Summary
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    Smooth polyurethane surfaces on artificial hearts reduced thrombus formation compared to rough Dacron-fibrilized surfaces. This suggests turbulent flow, not anticoagulation, is key to preventing blood clots in artificial hearts.

    Area of Science:

    • Biomedical Engineering
    • Cardiovascular Research
    • Materials Science

    Background:

    • Thromboembolism remains a significant complication in patients with artificial heart devices.
    • Understanding the surface properties and flow dynamics that contribute to thrombus formation is crucial for improving device safety and efficacy.

    Purpose of the Study:

    • To investigate the influence of surface characteristics and anticoagulation on thrombus formation in the Jarvik III artificial heart.
    • To identify specific sites within the artificial heart prone to thrombus deposition.

    Main Methods:

    • Twenty consecutive calf experiments were conducted using the Jarvik III artificial heart.
    • Two distinct surface materials were tested: Dacron-fibrilized silicone rubber and smooth polyurethane.

    Related Experiment Videos

  • Calves were divided into two groups: 10 received anticoagulation with Dacron-fibrilized surfaces, and 10 did not receive anticoagulation with smooth polyurethane surfaces.

    • Main Results:

    • Calves with smooth polyurethane hearts survived significantly longer (545 hours) than those with Dacron-fibrilized surfaces (296 hours).
    • Polyurethane surfaces remained clean, while Dacron-fibrilized surfaces showed variable thrombus coating.
    • Thrombus deposits were frequently found at the diaphragm-housing angle (75%) and on valves (41%), leading to emboli in vital organs.

    Conclusions:

    • Smooth polyurethane surfaces are superior to rough Dacron-fibrilized surfaces in minimizing thrombus formation in the Jarvik III artificial heart.
    • Turbulence and stagnation areas, rather than anticoagulation, are primary drivers of thrombus formation.
    • Future artificial heart designs must prioritize the elimination of turbulent and stagnant flow to prevent thromboembolic complications.