Basir Amir, de Groot Philip, Gründeman Paul F, Tersteeg Claudia, Maas Coen, Barendrecht Arjan, van Herwaarden Joost, Kluin Jolanda, Moll Frans, Pasterkamp Gerard, Roest Mark
From the Departments of *Experimental Cardiology, †Clinical Chemistry and Haematology, ‡Vascular Surgery, and §Cardio-Thoracic Surgery, UMC Utrecht, Netherlands.
Innovations (Phila). 2015 May-Jun;10(3):195-201. doi: 10.1097/IMI.0000000000000163.
Heart valve and vascular prosthesis implantation is a common procedure for patients with heart valve stenosis or regurgitation and dilated or obstructive vascular disease. Drawbacks of conventional valve prostheses are the requirement for anticoagulant drugs, moderate durability, and suboptimal resistance to fatigue and tear. Dyneema Purity fibers are made from ultra-high-molecular-weight polyethylene filaments and are very thin, flexible, and fatigue and abrasion resistant and have high strength. Therefore, prostheses made from Dyneema Purity fibers might be attractive for use in the minimally invasive treatment of valvular- and vascular diseases. The aim of this study was to test the hemocompatibility of Dyneema Purity fibers in contact with blood.
Real-time platelet adhesion in human blood of 3 volunteers was quantified after 5 minutes of perfusion on single filaments (Ø 15 μm) of Dyneema Purity and polyester fibers. Plasma thrombin generation was measured by fluoroscopy for patches of Dyneema Purity fibers and for 5 commonly used polyester and expanded polytetrafluoroethylene cardiovascular prostheses.
Platelet adhesion per 1 mm was 6 ± 1.4 on Dyneema Purity filaments and 15 ± 3.4 on polyester filaments (P = 0.02). Total formed thrombin and the time to peak of its maximum were noninferior for patches of Dyneema Purity fibers compared with the reference materials.
Dyneema Purity fibers are noninferior in adhesion and coagulation activation compared with commonly used cardiovascular prostheses.
心脏瓣膜和血管假体植入是心脏瓣膜狭窄或反流以及扩张性或阻塞性血管疾病患者的常见手术。传统瓣膜假体的缺点是需要使用抗凝血药物、耐久性一般以及抗疲劳和抗撕裂性能欠佳。迪尼玛纯净纤维由超高分子量聚乙烯长丝制成，非常细、柔韧，抗疲劳和耐磨，且强度高。因此，由迪尼玛纯净纤维制成的假体可能在瓣膜和血管疾病的微创治疗中具有吸引力。本研究的目的是测试迪尼玛纯净纤维与血液接触时的血液相容性。
在迪尼玛纯净纤维和聚酯纤维的单丝（直径15μm）上灌注5分钟后，对3名志愿者的人血中实时血小板黏附情况进行定量分析。通过荧光透视法测量迪尼玛纯净纤维贴片以及5种常用的聚酯和膨体聚四氟乙烯心血管假体的血浆凝血酶生成情况。
迪尼玛纯净纤维单丝上每1毫米的血小板黏附数为6±1.4，聚酯纤维单丝上为15±3.4（P = 0.02）。与参考材料相比，迪尼玛纯净纤维贴片的总凝血酶生成量及其峰值出现时间并不逊色。
与常用的心血管假体相比，迪尼玛纯净纤维在黏附及凝血激活方面并不逊色。
