title: Thrombotic Depositions on Right Impeller of Double-Ended Centrifugal Total Artificial Heart In Vivo.
abstract: The development of total artificial heart devices is a complex undertaking that includes chronic biocompatibility assessment of the device. It is considered particularly important to assess whether device design and features can be compatible long term in a biological environment. As part of the development program for the Cleveland Clinic continuous-flow total artificial heart (CFTAH), we evaluated the device for signs of thrombosis and biological material deposition in four animals that had achieved the intended 14-, 30-, or 90-day durations in each respective experiment. Explanted CFTAHs were analyzed for possible clot buildup at "susceptible" areas inside the pump, particularly the right pump impeller. Depositions of various consistency and shapes were observed. We here report our findings, along with macroscopic and microscopic analysis post explant, and provide computational fluid dynamics data with its potential implications for thrombus formation.
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
authors.forename: Jamshid H
authors.initials: JH
authors.lastname: Karimov
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
authors.forename: David J
authors.initials: DJ
authors.lastname: Horvath
authors.affiliation: Department of General Surgery, Transplant Center, Cleveland Clinic, Cleveland, OH.
authors.forename: Shinji
authors.initials: S
authors.lastname: Okano
authors.affiliation: SimuTech Group, Hudson, OH.
authors.forename: Mark
authors.initials: M
authors.lastname: Goodin
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
authors.forename: Gengo
authors.initials: G
authors.lastname: Sunagawa
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
authors.forename: Nicole
authors.initials: N
authors.lastname: Byram
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.|Department of Thoracic and Cardiovascular Surgery, Kaufman Center for Heart Failure, Cardiac Transplantation and Mechanical Circulatory Support, Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Nader
authors.initials: N
authors.lastname: Moazami
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
authors.forename: Leonard A R
authors.initials: LAR
authors.lastname: Golding
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fukamachi
mesh_terms: D000818:Animals; D002417:Cattle; D006354:Heart, Artificial / Q000009:adverse effects*; D057446:Hydrodynamics; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology* / Q000473:pathology
keywords: -Assisted circulation; -Heart-assist devices; -Right impeller; Total artificial heart