NDLI: Detection of circulating platelet microaggregates and surface microthrombi during continuous flow LVAD: evidence for shear-induced platelet activation

Content Provider	IEEE Xplore Digital Library
Author	Linneweber, J. Chow, T.W. Kawamura, M. Nose, Y. Moake, J.L.
Copyright Year	2002
Description	Author affiliation: Dept. of Cardiovascular Surg., Universitatsklinikum Charite der Humboldt, Berlin, Germany (Linneweber, J.)
Abstract	Continuous flow left ventricular assist devices (LVADs) are used for circulatory support. Despite heparin anticoagulation, thromboembolic complications occur frequently. It is believed that the thrombus formation is a result of activation of the intrinsic coagulation pathway by the pump surface. However, elevated fluid shear forces can activate platelets and induce platelet aggregates and thrombi. Shear-induced platelet activation requires von Willebrand factor (vWF) binding sequentially to platelet glycoprotein (GP) Ib-IX-V complex and GPIIb-IIIa. In this study, LVAD perfusion was studied, using an artificial circulatory system with heparinized whole blood. After perfusion, circulating platelet microaggregates were detected and quantified with flow cytometry. Surface microthrombi were detected with scanning electron microscopy and quantified with ELISA assay. Blocking vWF-GPIb interaction with aurin tricarboxylic acid (ATA) suppressed platelet aggregation almost completely and blocking vWF-GPIIb-IIIa with c7E3 reduced aggregation extensively. ATA or c7E3 also reduced surface microthrombi significantly, in a dose-dependent manner. Moreover, perfused platelets had a significant increase of surface-bound vWF, which was suppressed by ATA, but was not significantly reduced by the GPIIb-IIIa blocker, TAK-029. The results suggest that shear-induced platelet activation occurs during LVAD perfusion and the inhibition of shear-induced platelet functions may be useful in preventing thromboembolic complications during mechanical circulatory support.
Starting Page	1603
Ending Page	1604
File Size	219201
Page Count	2
File Format	PDF
ISBN	0780376129
ISSN	1094687X
DOI	10.1109/IEMBS.2002.1106559
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2002-10-23
Publisher Place	USA
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Blood Coagulation Scanning electron microscopy Adhesives Surgery Educational institutions Pumps Aggregates Heart Cardiology
Content Type	Text
Resource Type	Article

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