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Related Experiment Videos

Platelet activation and aggregation profile in prolonged external ventricular support.

Rémi Houël1, Elisabeth Mazoyer, Bernadette Boval

  • 1Service de Chirurgie Cardiaque, Hôpital Henri Mondor, Créteil, France. remihouel@hotmail.com

The Journal of Thoracic and Cardiovascular Surgery
|July 30, 2004
PubMed
Summary

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External ventricular assist device implantation leads to persistent platelet activation and inflammation, even with aspirin. This suggests ongoing risks for thromboembolic events in patients on mechanical support.

Area of Science:

  • Cardiology
  • Hematology
  • Biomedical Engineering

Background:

  • Platelet function is crucial in understanding thromboembolic events during prolonged mechanical circulatory support.
  • External ventricular assist devices (EVADs) are used for mechanical support, but their impact on platelet function requires investigation.

Purpose of the Study:

  • To investigate platelet activation, aggregation, and aspirin efficacy in patients with implanted EVADs.

Main Methods:

  • Prospective study of 15 patients up to 6 weeks post-EVAD implantation.
  • Weekly assessment of platelet function, including aspirin efficacy testing (ex vivo platelet aggregation).
  • Flow cytometry for glycoprotein expression (alphaIIbbeta3, Ibalpha, CD62P) and plasma levels of von Willebrand factor and fibrinogen.

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Main Results:

  • 26% of patients showed persistent arachidonic acid-induced platelet aggregation despite daily aspirin (250 mg).
  • Elevated CD62P levels persisted for 5 weeks post-surgery.
  • Plasma levels of fibrinogen and von Willebrand factor remained elevated throughout the study.

Conclusions:

  • EVAD implantation is associated with persistent platelet activation and a high inflammatory state.
  • Endothelial activation is also indicated, suggesting continued thromboembolic risk.
  • Aspirin efficacy may be limited in this patient population.