Acquired Von Willebrand Syndrome and Blood Pump Design

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

The existence of acquired von Willebrand syndrome (AVWS) in patients with continuous flow left ventricular assist devices (LVADs) is well documented and has been verified by numerous investigators. AVWS has not been observed to occur in pulsatile devices such as the SynCardia total artificial heart (TAH), the HeartMate XVE, and the Thoratec pulsatile ventricular assist device (PVAD) used as a single pump. AVWS can also occur in patients with aortic stenosis, ventricular septal defect, mitral stenosis, and patent ductus arteriosus. It has been experimentally verified that supraphysiologic shear stress that occurs under these conditions can cleave the von Willebrand molecule, but the critical magnitude of stress and duration is unclear. Limited experimental results demonstrate that shear stresses as low as 5 Pa (50 dyne/cm 2 ) can cause cleavage. Stresses in current centrifugal pumps can be as high as two orders of magnitude greater than this value. Pulsatile LVADs have stresses almost two orders of magnitude less than continuous flow LVADs. In order to improve continuous flow LVADs, the challenge for designers is to first determine the magnitude and duration of stress that is causing AVWS and then, if possible, design a pump below these stresses.

Original languageEnglish (US)
Pages (from-to)1119-1124
Number of pages6
JournalArtificial organs
Volume42
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Heart-Assist Devices
Left ventricular assist devices
Blood
Pumps
Shear stress
Artificial heart
Artificial Heart
Patent Ductus Arteriosus
Mitral Valve Stenosis
Centrifugal pumps
Ventricular Heart Septal Defects
Aortic Valve Stenosis
Research Personnel
Equipment and Supplies
Defects
Molecules

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Cite this

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title = "Acquired Von Willebrand Syndrome and Blood Pump Design",
abstract = "The existence of acquired von Willebrand syndrome (AVWS) in patients with continuous flow left ventricular assist devices (LVADs) is well documented and has been verified by numerous investigators. AVWS has not been observed to occur in pulsatile devices such as the SynCardia total artificial heart (TAH), the HeartMate XVE, and the Thoratec pulsatile ventricular assist device (PVAD) used as a single pump. AVWS can also occur in patients with aortic stenosis, ventricular septal defect, mitral stenosis, and patent ductus arteriosus. It has been experimentally verified that supraphysiologic shear stress that occurs under these conditions can cleave the von Willebrand molecule, but the critical magnitude of stress and duration is unclear. Limited experimental results demonstrate that shear stresses as low as 5 Pa (50 dyne/cm 2 ) can cause cleavage. Stresses in current centrifugal pumps can be as high as two orders of magnitude greater than this value. Pulsatile LVADs have stresses almost two orders of magnitude less than continuous flow LVADs. In order to improve continuous flow LVADs, the challenge for designers is to first determine the magnitude and duration of stress that is causing AVWS and then, if possible, design a pump below these stresses.",
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Acquired Von Willebrand Syndrome and Blood Pump Design. / Rosenberg, Gerson; Siedlecki, Christopher; Jhun, Choon-Sik; Weiss, William; Manning, Keefe B.; Deutsch, Steven; Pierce, William.

In: Artificial organs, Vol. 42, No. 12, 01.12.2018, p. 1119-1124.

Research output: Contribution to journalReview article

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