The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 248-255, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Thrombus generation within the artificial heart
DB Olsen, F Unger, H Oster, J Lawson, T Kessler, J Kolff and WJ Kolff
The sites of thrombus formation in the Jarvik III artificial heart were
studied in 20 consecutive calf experiments. Identical design and
implantation procedures were used with two different surfaces. The 10
anticoagulated calves receiving Dacron-fibrilized silicone rubber surfaces
survived an average of 296 hours. In contrast, the 10 nonanticoagulated
calves with smooth poyurethane hearts survived 545 hours. The polyurethane
surfaces were constantly clean. However, the rough surfaces were coated
with variable amounts of thrombi. The sharp angle between the diaphragm and
housing contained varying amounts of thrombi deposits in 75 per cent of the
cases. Thrombe deposition occurred on 41 per cent of the valves. These
thrombe were the source of emboli into the kidney, brain, and lungs.
Turbulences and stagnation areas generated thrombus formation.
Anticoagulation did not prevent thrombus formation. It would appear that
heart free of turbulence and stagnation areas must be designed to eliminate
thromboembolism.