Histologic features of thrombosis events with a centrifugal left ventricular assist device.
| Autor: | Jessen SL; Departments of Veterinary Pathobiology; Biomedical Engineering, Texas A&M University, College Station, Texas., Kaulfus CN; Departments of Veterinary Pathobiology., Chorpenning K; Medtronic, Miami Lakes, Florida., Ginn-Hedman AM; Biomedical Engineering, Texas A&M University, College Station, Texas., Tamez D; Medtronic, Miami Lakes, Florida., Weeks BR; Departments of Veterinary Pathobiology. Electronic address: BWeeks@cvm.tamu.edu. |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2021 Jan; Vol. 40 (1), pp. 56-64. Date of Electronic Publication: 2020 Oct 28. |
| DOI: | 10.1016/j.healun.2020.10.007 |
| Abstrakt: | Background: Histology of thrombosis events in left ventricular assist devices (LVADs) may point to differences between the etiology of either ingested or de novo thrombus formation within LVADs. Materials ingested by the pump would have features suggestive of lifting and folding, whereas thrombi formed de novo would have uniform, parallel layers. This study tested this hypothesis in a cohort of explanted HeartWare Ventricular assist devices (HVADs) (Medtronic, Miami Lakes, Florida). Methods: Histology of thrombi from 59 explanted HVAD pumps were classified as presumed ingested, presumed de novo, or undeterminable on the basis of pre-defined criteria. The apparent size and location of the thrombotic materials were noted. Results: Histologically, all thrombotic materials were either presumed to be ingested (73%; 95 of 130 total histology cassettes examined) or of undeterminable origin (27%; 35 of 130 histology cassettes). Undetermined origin commonly was due to a lack of sufficient material for analysis. The larger materials (>800 mm 3 ) tended to be in the inflow region. The most common finding was smaller thrombotic materials (<150 mm 3 ) within the pump (64%; 38 of 59 HVADs); when these smaller materials were ingested by the pump, they were most often found within the smaller flow pathways within the pump. Conclusions: Our study suggests that the thrombi within HVAD pumps are commonly ingested materials rather than de novo thrombus formation within the pump. Further research to understand the source of this ingested material and the consideration to mitigate this complication should be considered. (Copyright © 2020 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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