Pathological sequelae of implantation of intracorporeal left ventricular assist devices in the calf.
Thromboembolic complications have previously been a major pathological complication of left ventricular assist device (LVAD) insertion and appear to be a consequence of the use of smooth polyurethane linings. Textured biomaterial surfaces are designed to attract a stable coagulum which becomes organized to form a neointima. We describe the pathological changes following experimental implantation of textured-surface LVADs in calves. The incidence of systemic embolization from such linings appears to be low. Surface modifications with cell seeding offer the possibility of further reduction in incidence of this problem. However, degradation of prosthetic valves may be a potential source of emboli and infection. With these complications minimized, the most significant pathological changes observed appear to relate to the device haemodynamics. At present renovascular changes associated with systemic hypertension appear to be the greatest potential problem for the long-term use of these devices.
Coumbe
A
A
Department of Morbid Anatomy, Royal London Hospital, U.K.
Keefe
M B
MB
Salih
V
V
Reynolds
P S
PS
Graham
T R
TR
Berry
C L
CL
D000818:Animals; D001672:Biocompatible Materials; D002319:Cardiovascular System / Q000473:pathology; D002417:Cattle; D002490:Central Nervous System / Q000473:pathology; D004867:Equipment Design; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006973:Hypertension / Q000209:etiology*; D007668:Kidney / Q000473:pathology; D008099:Liver / Q000473:pathology; D008168:Lung / Q000473:pathology; D013154:Spleen / Q000473:pathology; D013927:Thrombosis / Q000209:etiology*
D001672:Biocompatible Materials