device thrombogenicity emulation a novel method for optimizing mechanical circulatory support device thromboresistance设备thrombogenicity仿真新方法优化机械循环thromboresistance支持设备.pdfVIP

Device Thrombogenicity Emulation: A Novel Method for Optimizing Mechanical Circulatory Support Device Thromboresistance 1 1 1 1 3 2 Gaurav Girdhar , Michalis Xenos , Yared Alemu , Wei-Che Chiu , Bryan E. Lynch , Jolyon Jesty , Shmuel 1 4 1 Einav , Marvin J. Slepian , Danny Bluestein * 1 Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, United States of America, 2 Department of Hematology, Stony Brook University, Stony Brook, New York, United States of America, 3 MicroMed Cardiovascular Inc., Houston, Texas, United States of America, 4 Sarver Heart Center, University of Arizona, Tucson, Arizona, United States of America Abstract Mechanical circulatory support (MCS) devices provide both short and long term hemodynamic support for advanced heart failure patients. Unfortunately these devices remain plagued by thromboembolic complications associated with chronic platelet activation – mandating complex, lifelong anticoagulation therapy. To address the unmet need for enhancing the thromboresistance of these devices to extend their long term use, we developed a universal predictive methodology entitled Device Thrombogenicity Emulation (DTE) that facilitates optimizing the thrombogenic performance of any MCS device – ideally to a level that may obviate the need for mandatory anticoagulation. DTE combines in silico numerical simulations with in vitro measurements by correlating device hemodynamics with platelet activity coagulation markers – before and after iterative design modifications aimed at achieving optimized thrombogenic performance. DTE proof-of- concept is demonstrated by compa