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Updated: Jun 22, 2026
09:15
In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Haemolysis in patients with ventricular assist devices: major differences between systems
Claudia Heilmann1, Ulrich Geisen, Christoph Benk
1Department of Cardiovascular Surgery, University Medical Center Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany.
Summary
Ventricular assist device (VAD) implantation can cause hemolysis, a condition where red blood cells break down. Hemolysis is most severe with biventricular assist devices (BVADs) and least with centrifugal left ventricular assist devices (LVADs).
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Hematology
Background:
- Ventricular assist devices (VADs) are crucial for end-stage heart failure.
- Hemolysis, or red blood cell destruction, is a significant complication of certain VAD types.
- Released hemoglobin and lactate dehydrogenase (LDH) are key indicators of hemolysis.
Purpose of the Study:
- To investigate and compare the degree of hemolysis in patients supported by different types of VADs.
- To assess the role of haptoglobin, haemopexin, free hemoglobin, and LDH in quantifying VAD-induced hemolysis.
Main Methods:
- Analysis of five patients with centrifugal left ventricular assist devices (LVADs), ten with axial LVADs, and seven with biventricular assist devices (BVADs).
- Measurements of haptoglobin, haemopexin, free hemoglobin, LDH, total hemoglobin, hematocrit, and transfusion requirements preoperatively and at multiple time points post-implantation.
- Comparison of hemolysis markers across different VAD support types.
Main Results:
- Centrifugal LVADs showed minimal hemolysis with normal haptoglobin/haemopexin and moderately increased LDH.
- Axial LVADs exhibited lower haptoglobin/haemopexin and higher free hemoglobin/LDH compared to centrifugal LVADs.
- BVADs resulted in severe hemolysis, characterized by near-complete depletion of haptoglobin/haemopexin and significantly elevated free hemoglobin/LDH.
Conclusions:
- Hemolysis severity varies significantly with VAD type, being most pronounced in BVADs.
- Axial LVADs demonstrate moderate hemolysis, while centrifugal LVADs show the least erythrocyte damage.
- Haptoglobin, haemopexin, and free hemoglobin levels are valuable biomarkers for assessing VAD-associated hemolysis.
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