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

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 cust...

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Bibliographic Details
Published in:Artificial organs 2018-09, Vol.42 (9), p.879-890
Main Authors: Horobin, Jarod T., Simmonds, Michael J., Nandakumar, Deepika, Gregory, Shaun D., Tansley, Geoff, Pauls, Jo P., Girnghuber, Angela, Balletti, Nicoletta, Fraser, John F.
Format: Article
Language:English
Subjects:
Adenosine diphosphate
Adult
Agglomeration
Biomarkers
Blood
Blood circulation
Blood flow
Blood platelets
Blood pumps
Collagen
Deformability
Deformation
Differential pressure
Erythrocyte
Erythrocyte Deformability
Erythrocytes
Erythrocytes - physiology
Flow velocity
Formability
Heart
Heart-Assist Devices
Hemodynamics - physiology
Hemoglobin
Hemolysis
Humans
Male
Mechanical circulatory support
Mercury
Models, Cardiovascular
Modulation
Nitric oxide
Nitric-oxide synthase
Physiological effects
Platelet aggregation
Pulsatile Flow - physiology
Pulsatility
Rheology
Ristocetin
Rotary blood pump
Shear stress
Stress, Mechanical
Thromboembolism
Ventricular assist device
Von Willebrand factor
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Summary: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 
ISSN:0160-564X
1525-1594
DOI:10.1111/aor.13142