The influence of surface roughness on the damage of von Willebrand Factor under shear flow condition

2021 ◽  
pp. 039139882110569
Author(s):  
Xu Mei ◽  
Bin Lu ◽  
Min Zhong ◽  
Yuxin Zhu ◽  
Liudi Zhang ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Surface Roughness ◽  
Flow Condition ◽  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Blood Damage ◽  
Mechanical Circulatory Support Devices ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Support Devices

Despite technological advances in mechanical circulatory support devices to treat end-stage heart failure, blood damage induced by non-physiological shear stress in operation often triggered clinical hemocompatibility complications. The loss of high molecular weight von Willebrand Factor (HMW-VWF) has been considered as an essential cause of gastrointestinal bleeding. In addition to the mechanics factors, interface factors may also affect blood damage, especially the surface characteristics. In this study, the effect of surface roughness on VWF damage under flow condition was investigated. A roller pump circulation experimental platform with a roughness embedded sample chamber was constructed to provide blood shearing flow condition. VWF molecular weight analysis, VWF antigen (VWF-Ag) concentration assay, and VWF ristocetin cofactor activity (VWF-Rico) assay were performed on the sheared blood samples. These variables are the main functional indicators of VWF. It was found that the surface roughness induced VWF damage is mainly caused by the loss of HMW-VWF rather than reducing the total amount of VWF. The threshold value of surface roughness for a rapid increase in the degradation of HMW-VWF under low flow rate was obtained between Ra 0.4 and 0.6 μm, which was smaller than the threshold for hemolysis. Our findings indicated that VWF is more sensitive to the interface factor of surface roughness than red blood cells, thus has a higher requirement for blood pump design. It could provide reference for the material design and processing in developing mechanical circulatory support devices.

Acquired von Willebrand Syndrome with Mechanical Circulatory Support

2019 ◽  
pp. 269-276
Author(s):  
Evan C. Klein ◽  
Lisa Baumann Kreuziger
Keyword(s):  
Molecular Weight ◽  
Von Willebrand Factor ◽  
Mechanical Circulatory Support ◽  
Axial Flow ◽  
Circulatory Support ◽  
Severe Bleeding ◽  
Acquired Von Willebrand Syndrome ◽  
Mechanical Circulatory Support Devices ◽  
Von Willebrand ◽  
Willebrand Factor

Acquired von Willebrand syndrome occurs in the setting of mechanical circulatory support from device-associated sheer stress, which changes the quaternary structure of high-molecular-weight von Willebrand factor multimers, exposing the cleavage site for ADAMTS-13. Once cleaved, lower-molecular-weight multimers lose their affinity for binding platelets, increasing the susceptibility to bleeding complications. Acquired von Willebrand syndrome has been described in all the currently approved continuous-flow mechanical circulatory support devices. Although theoretically the risk of von Willebrand factor multimer degradation is increased at the higher rotational speeds of axial-flow pumps, disease severity does not differ greatly between axial- and centrifugal-flow devices. Disease-specific therapies for acquired von Willebrand syndrome have not been well studied in patients supported by mechanical circulatory devices. Case reports and case series have noted beneficial effects from octreotide, doxycycline, desmopressin, or Humate-P treatment for patients with recurrent severe bleeding.

Development of Mechanical Circulatory Support Devices: 55 Years and Counting

2021 ◽  
Vol 32 (4) ◽  
pp. 424-433
Author(s):  
Emalie Petersen
Keyword(s):  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Circulatory Support ◽  
Left Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Assist Devices ◽  
Left Ventricular Assist ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices

Heart failure is a leading cause of morbidity and mortality in the United States. Treatment of this condition increasingly involves mechanical circulatory support devices. Even with optimal medical therapy and use of simple cardiac devices, heart failure often leads to reduced quality of life and a shortened life span, prompting exploration of more advanced treatment approaches. Left ventricular assist devices constitute an effective alternative to cardiac transplantation. These devices are not without complications, however, and their use requires careful cooperative management by the patient’s cardiology team and primary care provider. Left ventricular assist devices have undergone many technological advancements since they were first introduced, and they will continue to evolve. This article reviews the history of different types of left ventricular assist devices, appropriate patient selection, and common complications in order to increase health professionals’ familiarity with these treatment options.

scholarly journals Evaluation of Nickel-Cadmium Battery Packs for Mechanical Circulatory Support Devices

ASAIO Journal ◽  
1993 ◽  
Vol 39 (3) ◽  
pp. M423-M426 ◽  
Author(s):  
Gregory K. MacLean ◽  
Peter A. Aiken ◽  
William A. Adams ◽  
Tofy Mussivand
Keyword(s):  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Battery Packs ◽  
Mechanical Circulatory Support Devices ◽  
Support Devices ◽  
Nickel Cadmium
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