Platelet adhesion emulation: A novel method for estimating the device thrombosis potential of a ventricular assist device

Int J Artif Organs. 2020 Apr;43(4):252-257. doi: 10.1177/0391398819885946. Epub 2019 Nov 11.

Abstract

Device thrombosis inside ventricular assist devices remains a limitation to their long-term clinical use. Thrombosis potential exists in almost all ventricular assist devices because the device-induced high shear stress and vortices can activate platelets, which then aggregate and adhere to the surfaces inside the ventricular assist device. To decrease the device thrombosis potential of long-term use of ventricular assist devices, a methodology entitled platelet adhesion emulation for predicting the thrombosis potential and thrombosis position inside the ventricular assist devices is developed. The platelet adhesion emulation methodology combines numerical simulations with in vitro experiments by correlating the structure of the flow passage components within the ventricular assist device with the platelet adhesion to estimate the thrombosis potential and location, with the goal of developing ventricular assist devices with optimized antithrombotic performance. Platelet adhesion emulation is aimed at decreasing the device thrombus potential of ventricular assist devices. The platelet adhesion emulation effectiveness is validated by simulating and testing an axial left ventricular assist device. The blood velocity relative to the surfaces of the flow passage components is calculated to estimate the platelet adhesion potential, indicating the probability of thrombus formation on the surfaces. Platelet adhesion emulation experiments conducted in a mock circulation loop with pump prototypes show the distribution of platelet adhesion on the surfaces. This methodology of emulating the device thrombosis distribution indicates the potential for improving the component structure and reducing the device thrombosis of ventricular assist devices.

Keywords: Ventricular assist device; computational fluid dynamics; device thrombosis; platelet activation; platelet adhesion.

MeSH terms

  • Blood Platelets
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Models, Cardiovascular
  • Platelet Adhesiveness / physiology*
  • Shear Strength
  • Stress, Mechanical
  • Thrombosis / etiology*