Hematologic and Hemostatic Complications Associated with Long‐Term Use of Total Artificial Heart

Clinical and Experimental Observations

Hamid Al-Mondhiry, Walter Pae, Gerson Rosenberg, William S. Pierce

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Abstract: The two most serious complications associated with long‐term use of a total artificial heart (TAH) are thromboembolism and infection. In this article, we review our experience in one patient implanted with a pneumatic TAH for 396 days, and in 24 calves implanted with the same type of device for 70 to 353 (median 150) days. During his survival with the TAH, our patient suffered several thromboembolic episodes despite adequate anti‐coagulation with warfarin. Autopsy showed widespread thrombotic lesions, mostly in the brain. Throughout his survival, the patient had markedly elevated plasma β‐thromboglobulin and fibrinopeptide A levels, indicating sustained activation of platelets and the coagulation system secondary to blood contact with the artificial surface. Long‐term use of TAH in calves causes significant mechanical hemolytic anemia and a small reduction in the total leukocyte and neutrophil counts. The platelet count normalized to preirnplantation levels by 25 to 35 weeks. At autopsy, thrombotic lesions and organ infarction were noted in 13 calves, and major septic complications were documented in 10 animals. Although impressive gains in the clinical and experimental use of TAH were achieved during the last 15 years, thromboembolism and infection remain challenging problems.

Original languageEnglish (US)
Pages (from-to)83-89
Number of pages7
JournalArtificial organs
Volume16
Issue number1
DOIs
StatePublished - Jan 1 1992

Fingerprint

Artificial heart
Artificial Heart
Hemostatics
Thromboembolism
Platelets
Autopsy
Fibrinopeptide A
Survival
Hemolytic Anemia
Platelet Activation
Warfarin
Infection
Coagulation
Platelet Count
Leukocyte Count
Pneumatics
Infarction
Brain
Animals
Neutrophils

All Science Journal Classification (ASJC) codes

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

Cite this

@article{b9d8de54e9eb4125a06b7c1d58b02169,
title = "Hematologic and Hemostatic Complications Associated with Long‐Term Use of Total Artificial Heart: Clinical and Experimental Observations",
abstract = "Abstract: The two most serious complications associated with long‐term use of a total artificial heart (TAH) are thromboembolism and infection. In this article, we review our experience in one patient implanted with a pneumatic TAH for 396 days, and in 24 calves implanted with the same type of device for 70 to 353 (median 150) days. During his survival with the TAH, our patient suffered several thromboembolic episodes despite adequate anti‐coagulation with warfarin. Autopsy showed widespread thrombotic lesions, mostly in the brain. Throughout his survival, the patient had markedly elevated plasma β‐thromboglobulin and fibrinopeptide A levels, indicating sustained activation of platelets and the coagulation system secondary to blood contact with the artificial surface. Long‐term use of TAH in calves causes significant mechanical hemolytic anemia and a small reduction in the total leukocyte and neutrophil counts. The platelet count normalized to preirnplantation levels by 25 to 35 weeks. At autopsy, thrombotic lesions and organ infarction were noted in 13 calves, and major septic complications were documented in 10 animals. Although impressive gains in the clinical and experimental use of TAH were achieved during the last 15 years, thromboembolism and infection remain challenging problems.",
author = "Hamid Al-Mondhiry and Walter Pae and Gerson Rosenberg and Pierce, {William S.}",
year = "1992",
month = "1",
day = "1",
doi = "10.1111/j.1525-1594.1992.tb00272.x",
language = "English (US)",
volume = "16",
pages = "83--89",
journal = "Artificial Organs",
issn = "0160-564X",
publisher = "Wiley-Blackwell",
number = "1",

}

Hematologic and Hemostatic Complications Associated with Long‐Term Use of Total Artificial Heart : Clinical and Experimental Observations. / Al-Mondhiry, Hamid; Pae, Walter; Rosenberg, Gerson; Pierce, William S.

In: Artificial organs, Vol. 16, No. 1, 01.01.1992, p. 83-89.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hematologic and Hemostatic Complications Associated with Long‐Term Use of Total Artificial Heart

T2 - Clinical and Experimental Observations

AU - Al-Mondhiry, Hamid

AU - Pae, Walter

AU - Rosenberg, Gerson

AU - Pierce, William S.

PY - 1992/1/1

Y1 - 1992/1/1

N2 - Abstract: The two most serious complications associated with long‐term use of a total artificial heart (TAH) are thromboembolism and infection. In this article, we review our experience in one patient implanted with a pneumatic TAH for 396 days, and in 24 calves implanted with the same type of device for 70 to 353 (median 150) days. During his survival with the TAH, our patient suffered several thromboembolic episodes despite adequate anti‐coagulation with warfarin. Autopsy showed widespread thrombotic lesions, mostly in the brain. Throughout his survival, the patient had markedly elevated plasma β‐thromboglobulin and fibrinopeptide A levels, indicating sustained activation of platelets and the coagulation system secondary to blood contact with the artificial surface. Long‐term use of TAH in calves causes significant mechanical hemolytic anemia and a small reduction in the total leukocyte and neutrophil counts. The platelet count normalized to preirnplantation levels by 25 to 35 weeks. At autopsy, thrombotic lesions and organ infarction were noted in 13 calves, and major septic complications were documented in 10 animals. Although impressive gains in the clinical and experimental use of TAH were achieved during the last 15 years, thromboembolism and infection remain challenging problems.

AB - Abstract: The two most serious complications associated with long‐term use of a total artificial heart (TAH) are thromboembolism and infection. In this article, we review our experience in one patient implanted with a pneumatic TAH for 396 days, and in 24 calves implanted with the same type of device for 70 to 353 (median 150) days. During his survival with the TAH, our patient suffered several thromboembolic episodes despite adequate anti‐coagulation with warfarin. Autopsy showed widespread thrombotic lesions, mostly in the brain. Throughout his survival, the patient had markedly elevated plasma β‐thromboglobulin and fibrinopeptide A levels, indicating sustained activation of platelets and the coagulation system secondary to blood contact with the artificial surface. Long‐term use of TAH in calves causes significant mechanical hemolytic anemia and a small reduction in the total leukocyte and neutrophil counts. The platelet count normalized to preirnplantation levels by 25 to 35 weeks. At autopsy, thrombotic lesions and organ infarction were noted in 13 calves, and major septic complications were documented in 10 animals. Although impressive gains in the clinical and experimental use of TAH were achieved during the last 15 years, thromboembolism and infection remain challenging problems.

UR - http://www.scopus.com/inward/record.url?scp=0026506041&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026506041&partnerID=8YFLogxK

U2 - 10.1111/j.1525-1594.1992.tb00272.x

DO - 10.1111/j.1525-1594.1992.tb00272.x

M3 - Article

VL - 16

SP - 83

EP - 89

JO - Artificial Organs

JF - Artificial Organs

SN - 0160-564X

IS - 1

ER -