151. Left ventricular assist device implantation causes platelet dysfunction and proinflammatory platelet-neutrophil interaction.
- Author
-
Granja, Tiago, Magunia, Harry, Schüssel, Patricia, Fischer, Claudius, Prüfer, Thomas, Schibilsky, David, Serna-Higuita, Lina, Wendel, Hans Peter, Schlensak, Christian, Häberle, Helene, Rosenberger, Peter, and Straub, Andreas
- Subjects
HEART assist devices ,CORONARY artery bypass ,BLOOD platelets ,BLOOD platelet aggregation ,AORTIC valve transplantation ,ARTIFICIAL blood circulation - Abstract
Blood flow through left ventricular assist devices (LVAD) may induce activation and dysfunction of platelets. Dysfunctional platelets cause coagulation disturbances and form platelet-neutrophil conjugates (PNC), which contribute to inflammatory tissue damage. This prospective observational cohort study investigated patients, who underwent implantation of a LVAD (either HeartMate II (HM II) (n = 7) or HeartMate 3 (HM 3) (n = 6)) and as control patients undergoing coronary artery bypass grafting (CABG) and/or aortic valve replacement (AVR) (n = 10). We performed platelet and leukocyte flow cytometry, analysis of platelet activation markers, and platelet aggregometry. Platelet CD42b expression was reduced at baseline and perioperatively in HM II/3 compared to CABG/AVR patients. After surgery the platelet activation marker β-thromboglobulin and platelet microparticles increased in all groups while platelet aggregation decreased. Platelet aggregation was more significantly impaired in LVAD compared to CABG/AVR patients. PNC were higher in HM II compared to HM 3 patients. We conclude that LVAD implantation is associated with platelet dysfunction and proinflammatory platelet-leukocyte binding. These changes are less pronounced in patients treated with the newer generation LVAD HM 3. Future research should identify device-specific LVAD features, which are associated with the least amount of platelet activation to further improve LVAD therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF