The blood interface at artificial surfaces within a left ventricular assist system

A left ventricular assist system presents a very complex set of interfaces to the blood. The interactions of the various components, their junctions, and fluid dynamic effects have been discussed at a macroscopic, cellular and molecular level. Failure of any part of the system can seriously compromise LVAS function or host response whether due to gross thrombosis with occlusion, proliferative PNI formation, or thromboembolic events. It has been stated that: "When artificial hearts are designed properly, nearly any surface goes." Unfortunately, the blood interface within any circulatory support system, and indeed in much simpler systems, is a much more complex function than design, which includes the surface, materials and many other factors (Table 6).