The fluid dynamic effect on protein adsorption in left ventricular assist devices.

Plasma protein adsorption onto an artificial surface is strongly influenced by not only the surface characteristics of materials, but also by the fluid dynamics inside the blood pump, and it would influence subsequent platelet adhesion or activation, which plays a major role in the initiation of thrombus formation at the blood-material interface in vivo. In vitro flow visualization of an electrohydraulic LVAD was performed by a video camera (CCD, Hitachi) and an image processor (PC VISION PLUS) with an IBM PC. The electrohydraulic LVADs were implanted in mongrel dogs of approximately 20 kg. The authors sectioned the blood contacted ventricle after animal death according to the level of shear rate. Because analysis of adsorbed protein might be influenced by the size of the ventricle segment, the number of segments was limited to eight per ventricle. Platelet adhesion and its morphology were observed by scanning electron microscopy (SEM). Adsorbed plasma proteins (fibrinogen, albumin, and IgG) on each segment were quantified by enzyme linked immunosorbent assay (ELISA). The specimens were soaked in 2% (wt/vol) SDS/PBS for 2 days and the released protein concentration assessed. A well developed large vortex was observed at the center of the artificial ventricle. Polyurethane blood pumps displayed different degrees of protein adsorption and subsequent platelet adhesion on each segment.