Mechanical Blood Trauma in Circulatory-Assist Devices
9. Concluding remarks
The act of pumping blood through an external circuit introduces extraneous forces that can activate or destroy plasma proteins and cellular components of blood. Simply stated, the key areas of focus for prevention of blood damage are the temporal generation of shear stress and heat. However, from these two simple concepts arise the complexities of geometry, machinery and energy transmission of pump and oxygenator design. Computational fluid dynamics methods can assist in the design process, but empirical testing both in vitro and in vivo is necessary to determine whether a device is truly “hemocompatible”. These tests are ultimately time-intensive and can be cost prohibitive, but they are necessary to ensure that the device will be successful in the clinical settings and achieve the ultimate goals of prolonging patient lives with excellent quality of life over the predictable lifespan of the device.