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Updated: May 18, 2026
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In Vitro Model of Physiological and Pathological Blood Flow with Application to Investigations of Vascular Cell Remodeling
Published on: November 3, 2015
Arterial wall histology in chronic pulsatile-flow and continuous-flow device circulatory support
Evgenij V Potapov1, Nikolay Dranishnikov, Lars Morawietz
1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin. potapov@dhzb.de
Summary
Continuous-flow (CF) ventricular assist devices (VAD) do not negatively impact arterial wall health in end-organ vasculature during long-term use. This study found no significant differences in vascular alterations between CF and pulsatile-flow (PF) VAD recipients.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Pathology
Background:
- Continuous-flow (CF) ventricular assist devices (VAD) are crucial for end-stage heart failure treatment.
- Long-term effects of CF VADs on arterial wall motion, blood pressure, and end-organ sclerosis remain incompletely understood.
Purpose of the Study:
- To investigate the long-term impact of CF VADs on end-organ arterial wall properties compared to pulsatile-flow (PF) VADs.
- To assess vascular alterations in liver, kidney, coronary arteries, and brain following VAD implantation.
Main Methods:
- Autopsy tissue samples from 27 VAD recipients (16 CF, 9 PF) with support >180 days were histologically examined.
- Vascular alterations assessed included perivascular/intravascular infiltrate, wall thickness, thrombosis, endothelial changes, necrosis, and fibrosis.
- Demographic, clinical, and pharmacologic data were retrospectively analyzed.
Main Results:
- No significant differences in histological arterial wall characteristics were found between CF and PF VAD groups.
- Mean arterial pressure, systolic, and diastolic pressures were similar between groups throughout the follow-up period, with minor exceptions early post-implantation.
- Amiodarone use was higher in the CF group.
Conclusions:
- Long-term mechanical circulatory support with CF VADs does not adversely affect the arterial wall properties of end-organ vasculature.
- CF VADs appear to be a safe option regarding vascular health in the long term.
