In vivo preclinical anticoagulation regimens after implantation of ventricular assist devices.
Ventricular assist devices (VADs) have demonstrated successfully their ability to treat failing circulation of patients with end-stage heart failure. Among the main obstacles with these VADs is thromboembolic events that increase device-related morbidity and mortality. Prior to the clinical application of any newly developed VAD, the feasibility of the device is tested on animal models. Animal species have different hemostatic properties than human patients, and this factor creates a margin of error when comparing the occurrence of VAD-induced thrombosis in an animal versus a human. This detailed literature review provides a thorough documentation of various preclinical anticoagulation protocols used to date, including their outcomes and recommendations for future anticoagulation management strategies. In summary, the outcomes favor a sheep or pig model over other animal models, and discourage the application of a single anticoagulative agent to improve outcomes with any of the currently available devices.
Saeed
Diyar
D
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Fukamachi
Kiyotaka
K
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004353:Drug Evaluation, Preclinical; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006487:Hemostasis; D006801:Humans; D013927:Thrombosis / Q000188:drug therapy* / Q000209:etiology
D000925:Anticoagulants