Design Optimization of Rotary Blood Pumps: Alternatives to Anticoagulation Therapy

Mechanical circulatory support (MCS) devices such as the ventricular assist devices (VADs) provide life saving short-term bridge-to-transplant solutions (1) to a large proportion of patients who suffer from chronic heart failure. Although hemodynamically efficient, such devices are burdened with high incidence of thromboembolic events due to non-physiological flow past constricted geometries where platelets (the principal cellular clotting elements in blood) are exposed to elevated shear stresses and exposure times (2) — requiring mandatory anticoagulation. We recently developed an optimization methodology — Device Thrombogenicity Emulator (DTE)(3) — that integrates device specific hemodynamic stresses (from numerical simulations) with experimental measurements of platelet activation. The DTE was successfully applied by our group to measure / optimize the thromboresistance of mechanical heart valves (MHV) (3, 4).