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Experience with vascular grafts in total artificial heart replacement
H Weidemann1, K M Müller, E Hennig
1Chirurgische Klinik und Poliklinik, Universitätsklinikum Rudolf Virchow, Standort Charlottenburg, Freie Universität Berlin, West Germany.
The International Journal of Artificial Organs
|May 1, 1990
Summary
Total artificial heart replacement can cause dangerous thrombus formation and stenosis at the graft-host connections. These complications, particularly pulmonary artery stenosis, were observed in calves and impacted survival rates.
Area of Science:
- Biomedical Engineering
- Cardiovascular Surgery
- Pathology
Background:
- Total artificial heart (TAH) replacement necessitates vascular grafts for pump attachment.
- Interfacial reactions between grafts and the vascular system can lead to complications.
Purpose of the Study:
- To investigate morphological alterations at graft anastomoses following TAH replacement in calves.
- To identify the incidence and nature of thrombus formation and tissue overgrowth.
Main Methods:
- Morphological analysis of anastomoses in 36 calves surviving TAH replacement (1-7 months).
- Evaluation of thrombus formation, neointimal fibrous hyperplasia, and pannus growth.
Main Results:
- Thrombus growth in the outflow tract caused anastomotic stenosis in 41.7% of calves.
- Pulmonary artery stenosis was most common (93.3%), often with pannus growth (86.7%).
- Infected organized thrombus mimicked endocarditis in 73.3% of cases; pulmonary stenosis caused death in 5 animals.
Conclusions:
- Graft-host interfaces are prone to thrombus formation and excessive tissue growth (neointimal hyperplasia, pannus).
- Fluid mechanical design influences tissue growth and thrombus location.
- These reactions pose significant risks, including anastomotic stenosis and mortality, in TAH recipients.