Parallel flow arteriovenous shunt for the ex vivo evaluation of heparinized materials

The patency of heparin-polyvinyl alcohol (hep-PVA) coated polyethylene tubing was found to be significantly longer than control tubes coated with polyvinyl alcohol (PVA) but without heparin at low flow rates in dogs using a novel parallel flow arteriovenous shunt designed to avoid surgical artifacts. A standard Silastic chronic shunt (3.18 mm i.d.) was inserted between the iliac artery and vein of a dog. After a 2-week recovery period, a small diameter coated polyethylene tube (1.14 mm i.d.) was connected in parallel with the exteriorized portion of the chronic shunt through a pair of Silastic Y-connectors, so that less than 3% of the shunt flow was diverted into the test tube. The chronic shunt was reused many times over a greater than 6 month patency period, eliminating the need for frequent surgery and reducing interanimal variability in the results. The difference in patency between heparinized and control tubes was greater at higher mainshunt flow rates indicating the presence of a significant effect of the Y-connectors on platelet adhesion or aggregation. This effect was manifested in a time-dependent reduction in circulating platelet count. Scanning electron microscopy (SEM) examination of the midportion of the heparinized tubes after occlusion demonstrated the absence of platelet and fibrin deposits, unlike the control tubes without heparin. Although the Y-connectors played a significant role, they did not dominate the thrombotic processes occurring in this shunt and consequently the biological effectiveness of the immobilized heparin could be demonstrated.