Thrombus generation within the artificial heart.
The sites of thrombus formation in the Jarvik III artificial heart were studied in 20 consecutive calf experiments. Identical design and implantation procedures were used with two different surfaces. The 10 anticoagulated calves receiving Dacron-fibrilized silicone rubber surfaces survived an average of 296 hours. In contrast, the 10 nonanticoagulated calves with smooth poyurethane hearts survived 545 hours. The polyurethane surfaces were constantly clean. However, the rough surfaces were coated with variable amounts of thrombi. The sharp angle between the diaphragm and housing contained varying amounts of thrombi deposits in 75 per cent of the cases. Thrombe deposition occurred on 41 per cent of the valves. These thrombe were the source of emboli into the kidney, brain, and lungs. Turbulences and stagnation areas generated thrombus formation. Anticoagulation did not prevent thrombus formation. It would appear that heart free of turbulence and stagnation areas must be designed to eliminate thromboembolism.
D000818:Animals; D001777:Blood Coagulation / Q000187:drug effects; D002417:Cattle; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D006354:Heart, Artificial / Q000009:adverse effects*; D006493:Heparin / Q000627:therapeutic use; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology; D007674:Kidney Diseases / Q000209:etiology; D011093:Polyethylene Terephthalates / Q000009:adverse effects; D011140:Polyurethanes; D011474:Prosthesis Design; D011655:Pulmonary Embolism / Q000209:etiology; D012826:Silicone Elastomers; D013499:Surface Properties; D013923:Thromboembolism / Q000209:etiology*; D013997:Time Factors
D011093:Polyethylene Terephthalates; D011140:Polyurethanes; D012826:Silicone Elastomers; D006493:Heparin