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[Blood activation during long-term mechanical circulatory support].

M Kirsch1, E Vermes, B Boval

  • 1Service de chirurgie thoracique et cardiovasculaire, CNRS UPRESA 7054, hôpital Henri-Mondor, 51 avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. matthias.kirsch@hmn.ap-hop-paris.fr

Pathologie-Biologie
|February 15, 2005
PubMed
Summary

Mechanical circulatory support devices help heart failure patients but can cause bleeding and clotting. This review examines systemic effects of pulsatile and rotary blood pumps, highlighting unknown impacts of newer rotary pumps.

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Area of Science:

  • Cardiovascular Medicine
  • Biomedical Engineering
  • Hematology

Background:

  • Mechanical circulatory support (MCS) is approved for cardiogenic shock and end-stage heart failure.
  • MCS device recipients face high risks of bleeding, thrombo-embolism, and infection.
  • Systemic alterations in coagulation, fibrinolysis, inflammation, and immunity contribute to these complications.

Purpose of the Study:

  • To review the systemic consequences of long-term mechanical circulatory support.
  • To compare the systemic effects of pulsatile and non-pulsatile (rotary) blood pumps.

Main Methods:

  • Literature review of studies on systemic changes in MCS patients.
  • Focus on long-term circulatory support with both pulsatile and rotary devices.

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Main Results:

  • Existing studies primarily focus on pulsatile devices, leaving rotary pump effects less understood.
  • Systemic alterations in coagulation, fibrinolysis, inflammation, and immune responses are key.
  • The review synthesizes current knowledge on these changes.

Conclusions:

  • Understanding systemic consequences of MCS is crucial for patient management.
  • Further research is needed on the specific systemic effects of rotary blood pumps.
  • Optimizing MCS therapy requires addressing associated pathophysiological changes.