Speed Modulation of the HeartWare HVAD to Assess In Vitro Hemocompatibility of Pulsatile and Continuous Flow Regimes in a Rotary Blood Pump

Horobin, Jarod T, Simmonds, Michael J, Nandakumar, Deepika, Gregory, Shaun D, Tansley, Geoff, Pauls, Jo P, Girnghuber, Angela, Balletti, Nicoletta and Fraser, John F (2018) Speed Modulation of the HeartWare HVAD to Assess In Vitro Hemocompatibility of Pulsatile and Continuous Flow Regimes in a Rotary Blood Pump. Artificial organs, . doi:10.1111/aor.13142


Author Horobin, Jarod T
Simmonds, Michael J
Nandakumar, Deepika
Gregory, Shaun D
Tansley, Geoff
Pauls, Jo P
Girnghuber, Angela
Balletti, Nicoletta
Fraser, John F
Title Speed Modulation of the HeartWare HVAD to Assess In Vitro Hemocompatibility of Pulsatile and Continuous Flow Regimes in a Rotary Blood Pump
Journal name Artificial organs   Check publisher's open access policy
ISSN 1525-1594
Publication date 2018-05-03
Sub-type Article (original research)
DOI 10.1111/aor.13142
Open Access Status Not yet assessed
Abstract Although rotary blood pumps (RBPs) sustain life, blood exposure to continuous supra-physiological shear stress induces adverse effects (e.g., thromboembolism); thus, pulsatile flow in RBPs represents a potential solution. The present study introduced pulsatile flow to the HeartWare HVAD using a custom-built controller and compared hemocompatibility biomarkers (i.e., platelet aggregation, concentrations for ADAMTS13, von Willebrand factor (vWf), and free-hemoglobin in plasma (pfHb), red blood cell (RBC) deformability, and RBC-nitric oxide synthase (NOS) activity) between continuous and pulsatile flow in a blood circulation loop over 5 h. The HeartWare HVAD was operated using a custom-built controller, at continuous speed (3282 rev/min) or in a pulsatile mode (mean speed = 3273 rev/min, amplitude = 430 rev/min, frequency = 1 Hz) to generate a blood flow rate of 5.0 L/min, HVAD differential pressure of 90 mm Hg for continuous flow and 92 mm Hg for pulsatile flow, and systolic and diastolic pressures of 121/80 mm Hg. For both flow regimes, the current study found; (i) ADP- and collagen-induced platelet aggregation, and ADAMTS13 concentration significantly decreased after 5 h (P < 0.01; P < 0.05), (ii) ristocetin-induced platelet aggregation significantly increased after 45 min (P < 0.05), (iii) vWf concentration did not significantly differ at any time point, (iv) pfHb significantly increased after 5 h (P < 0.01), (v) RBC deformability improved during the continuous flow regime (P < 0.05) but not during pulsatile flow, and (vi) RBC-NOS activity significantly increased during continuous flow (15 min), and pulsatile flow (5 h; P < 0.05). The current study demonstrated: (i) speed modulation does not improve hemocompatibility of the HeartWare HVAD based on no observable differences being detected for routine biomarkers, and (ii) the time-course for increased RBC-NOS activity observed during continuous flow may have improved RBC deformability.
Keyword -Erythrocyte
-Hemolysis
-Mechanical circulatory support
-Pulsatility
-Rheology
-Rotary blood pump
-Shear stress
Ventricular assist device
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Pubmed Import
 
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Created: Wed, 09 May 2018, 10:05:40 EST