Liu Guang-Mao, Chen Hai-Bo, Hou Jian-Feng, Zhang Yan, Hu Sheng-Shou
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Int J Artif Organs. 2020 Apr;43(4):252-257. doi: 10.1177/0391398819885946. Epub 2019 Nov 11.
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.
心室辅助装置内部的器械血栓形成仍然限制了它们的长期临床应用。几乎所有心室辅助装置都存在血栓形成的可能性，因为装置引发的高剪切应力和涡流会激活血小板，随后血小板聚集并黏附于心室辅助装置内部的表面。为了降低长期使用心室辅助装置时的器械血栓形成可能性，开发了一种名为血小板黏附模拟的方法，用于预测心室辅助装置内部的血栓形成可能性和血栓形成位置。血小板黏附模拟方法通过将心室辅助装置内流动通道部件的结构与血小板黏附相关联，把数值模拟与体外实验相结合，以估计血栓形成可能性和位置，目标是开发出具有优化抗血栓性能的心室辅助装置。血小板黏附模拟旨在降低心室辅助装置的器械血栓形成可能性。通过对轴向左心室辅助装置进行模拟和测试，验证了血小板黏附模拟的有效性。计算相对于流动通道部件表面的血流速度，以估计血小板黏附可能性，这表明在这些表面形成血栓的概率。在带有泵原型的模拟循环回路中进行的血小板黏附模拟实验显示了血小板在表面的黏附分布情况。这种模拟器械血栓形成分布的方法表明了改善部件结构和减少心室辅助装置器械血栓形成的潜力。
