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Sakurai H, Fujiwara T, Ohuchi K, Hijikata W, Inoue Y, Maruyama O, Tahara T, Yokota S, Tanaka Y, Takewa Y, Mizuno T, Arai H. Innovative experimental animal models for real-time comparison of antithrombogenicity between two oxygenators using dual extracorporeal circulation circuits and indocyanine green fluorescence imaging. Artif Organs 2023; 47:77-87. [PMID: 35957489 DOI: 10.1111/aor.14380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/08/2022] [Accepted: 08/02/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Antithrombogenicity of extracorporeal membrane oxygenation (ECMO) devices, particularly oxygenators, is a current problem, with numerous studies and developments underway. However, there has been limited progress in developing methods to accurately compare the antithrombogenicity of oxygenators. Animal experiments are commonly conducted to evaluate the antithrombogenicity of devices; however, it is challenging to maintain a steady experimental environment. We propose an innovative experimental animal model to evaluate different devices in a constant experimental environment in real-time. METHODS This model uses two venous-arterial ECMO circuits attached to one animal (one by jugular vein and carotid artery, one by femoral vein and artery) and real-time assessment of thrombus formation in the oxygenator by indocyanine green (ICG) fluorescence imaging. Comparison studies were conducted using three pigs: one to compare different oxygenators (MERA vs. CAPIOX) (Case 1), and two to compare antithrombotic properties of the oxygenator (QUADROX) when used under different hydrodynamic conditions (continuous flow vs. pulsatile flow) (Cases 2 and 3). RESULTS Thrombi, visualized using ICG imaging, appeared as black dots on a white background in each oxygenator. In Case 1, differences in the site of thrombus formation and rate of thrombus growth were observed in real-time in two oxygenators. In Case 2 and 3, the thrombus region was smaller in pulsatile than in continuous conditions. CONCLUSIONS We devised an innovative experimental animal model for comparison of antithrombogenicity in ECMO circuits. This model enabled simultaneous evaluation of two different ECMO circuits under the same biological conditions and reduced the number of sacrificed experimental animals.
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Affiliation(s)
- Hironobu Sakurai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuhiro Ohuchi
- Center for Experimental Animals, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Hijikata
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Yusuke Inoue
- Advanced Medical Engineering Research Center, Asahikawa Medical University, Asahikawa, Japan
| | - Osamu Maruyama
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Tomoki Tahara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sachie Yokota
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yui Tanaka
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Yoshiaki Takewa
- Advanced Medical Engineering Research Center, Asahikawa Medical University, Asahikawa, Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Zhang M, Tansley GD, Dargusch MS, Fraser JF, Pauls JP. Surface Coatings for Rotary Ventricular Assist Devices: A Systematic Review. ASAIO J 2021; 68:623-632. [PMID: 34324447 DOI: 10.1097/mat.0000000000001534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Rotary ventricular assist devices (VADs) are frequently used to provide mechanical circulatory support to patients suffering from end-stage heart failure. Therefore, these devices and especially their pump impeller and housing components have stringent requirements on wear resistance and hemocompatibility. Various surface coatings have been investigated to improve the wear resistance or hemocompatibility of these devices. The aim of the present systematic review was to build a comprehensive understanding of these coatings and provide potential future research directions. A Boolean search for peer-reviewed studies was conducted in online databases (Web of Science, Scopus, PubMed, and ScienceDirect), and a preferred reporting items for systematic reviews and meta-analyses (PRISMA) process was followed for selecting relevant papers for analysis. A total of 45 of 527 publications were included for analysis. Eighteen coatings were reported to improve wear resistance or hemocompatibility of rotary VADs with the most common coatings being diamond-like carbon (DLC), 2-methacryloyloxyethyl phosphorylcholine (MPC), and heparin. Ninety-three percent of studies focused on hemocompatibility, whereas only 4% of studies focused on wear properties. Thirteen percent of studies investigated durability. This review provides readers with a systematic catalogue and critical review of surface coatings for rotary VADs. The review has identified that more comprehensive studies especially investigations on wear properties and durability are needed in future work.
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Affiliation(s)
- Meili Zhang
- From the Innovative Cardiovascular Engineering and Technology Laboratory, Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia School of Mechanical and Mining Engineering, University of Queensland, Brisbane, Queensland, Australia School of Engineering and Built Environment, Griffith University, Brisbane, Queensland, Australia School of Medicine, University of Queensland, Brisbane, Queensland, Australia School of Medicine, Griffith University, Brisbane, Queensland, Australia
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Seki H, Fujiwara T, Hijikata W, Murashige T, Tahara T, Yokota S, Ogata A, Ohuchi K, Mizuno T, Arai H. Evaluation of real-time thrombus detection method in a magnetically levitated centrifugal blood pump using a porcine left ventricular assist circulation model. Artif Organs 2021; 45:726-735. [PMID: 33432615 DOI: 10.1111/aor.13915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/16/2020] [Accepted: 01/04/2021] [Indexed: 01/08/2023]
Abstract
Pump thrombosis induces significant complications and requires timely detection. We proposed real-time monitoring of pump thrombus in a magnetically levitated centrifugal blood pump (mag-lev pump) without using additional sensors, by focusing on the changes in the displacement of the pump impeller. The phase difference between the current and displacement of the impeller increases with pump thrombus. This thrombus detection method was previously evaluated through simulated circuit experiments using porcine blood. Evaluation of real-time thrombus detection in a mag-lev blood pump was performed using a porcine left ventricular assist circulation model in this study. Acute animal experiments were performed five times using five Japanese domestic pigs. To create thrombogenic conditions, fibrinogen coating that induces thrombus formation in a short time was applied to the inner surfaces of the pump. An inflow and an outflow cannula were inserted into the apex of the left ventricle and the carotid artery, respectively, by a minimally invasive surgical procedure that allowed minimal bleeding and hypothermia. Pump flow was maintained at 1 L/min without anticoagulation. The vibrational frequency of the impeller (70 Hz) and its vibrational amplitude (30 μm) were kept constant. The thrombus was detected based on the fact that the phase difference between the impeller displacement and input current to the magnetic bearing increases when a thrombus is formed inside a pump. The experiment was terminated when the phase difference increased by over 1° from the lowest value or when the phase difference was at the lowest value 12 hours after commencing measurements. The phase difference increased by over 1° in three cases. The pump was stopped after 12 hours in two cases. Pump thrombi were found in the pump in three cases in which the phase difference increased by over 1°. No pump thrombus was found in the other two cases in which the phase difference did not increase. We succeeded in real-time thrombus monitoring of a mag-lev pump in acute animal experiments.
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Affiliation(s)
- Haruna Seki
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Hijikata
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan
| | - Tomotaka Murashige
- School of Engineering, Tokyo Institute of Technology, Tokyo, Japan.,Department of Advanced Surgical Technology Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoki Tahara
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sachie Yokota
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Asato Ogata
- Faculty of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsuhiro Ohuchi
- Department of Advanced Surgical Technology Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Hemocompatibility of new magnetically-levitated centrifugal pump technology compared to the CentriMag adult pump. Sci Rep 2020; 10:22055. [PMID: 33328596 PMCID: PMC7744571 DOI: 10.1038/s41598-020-78709-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 11/26/2020] [Indexed: 11/25/2022] Open
Abstract
The specific hemocompatibility properties of mechanical-circulatory-support (MCS)-pump technologies have not previously been described in a comparable manner. We thus investigated the hemocompatibility-indicating marker of a new magnetically-levitated (MagLev) centrifugal pump (MT-Mag) in a human, whole-blood mock-loop for 360 min using the MCS devices as a driving component. We compared those results with the CentriMag adult (C-Mag) device under the same conditions according to ISO10993-4. Blood samples were analyzed via enzyme-linked-immunosorbent-assay (ELISA) for markers of coagulation, complement system, and the inflammatory response. The time-dependent activation of the coagulation system was measured by detecting thrombin-anti-thrombin complexes (TAT). The activation of the complement system was determined by increased SC5b-9 levels in both groups. A significant activation of neutrophils (PMN-elastase) was detected within the C-Mag group, but not in the MT-Mag group. However, the amount of PMN-elastase at 360 min did not differ significantly between groups. The activation of the complement and coagulation system was found to be significantly time-dependent in both devices. However, coagulation activation as determined by the TAT level was lower in the MT-Mag group than in the C-Mag group. This slight disparity could have been achieved by the optimized secondary flow paths and surface coating, which reduces the interaction of the surface with blood.
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Seki H, Fujiwara T, Hijikata W, Murashige T, Maruyama T, Yokota S, Ogata A, Ouchi K, Mizuno T, Arai H. Verification of a thrombus induction method at the target point inside the blood pump using a fibrinogen coating for a thrombus detection study. Artif Organs 2020; 44:968-975. [DOI: 10.1111/aor.13743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Haruna Seki
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Tatsuki Fujiwara
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Wataru Hijikata
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | | | - Takuro Maruyama
- School of Engineering Tokyo Institute of Technology Tokyo Japan
| | - Sachie Yokota
- Faculty of Medicine Tokyo Medical and Dental University Tokyo Japan
| | - Asato Ogata
- Faculty of Medicine Tokyo Medical and Dental University Tokyo Japan
| | - Katsuhiro Ouchi
- Department of Advanced Surgical Technology Research and Development Tokyo Medical and Dental University Tokyo Japan
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
| | - Hirokuni Arai
- Department of Cardiovascular Surgery Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences Tokyo Japan
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Fujiwara T, Sakota D, Ohuchi K, Endo S, Tahara T, Murashige T, Kosaka R, Oi K, Mizuno T, Maruyama O, Arai H. Optical Dynamic Analysis of Thrombus Inside a Centrifugal Blood Pump During Extracorporeal Mechanical Circulatory Support in a Porcine Model. Artif Organs 2017; 41:893-903. [DOI: 10.1111/aor.12862] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/07/2016] [Accepted: 08/19/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Tatsuki Fujiwara
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Daisuke Sakota
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST)
| | - Katsuhiro Ohuchi
- Department of Advanced Surgical Technology Research and Development; Tokyo Medical and Dental University
| | - Shu Endo
- Center for Experimental Animals, Tokyo Medical and Dental University
| | - Tomoki Tahara
- Faculty of Medicine; Tokyo Medical and Dental University
| | - Tomotaka Murashige
- Graduate School of Science and Technology; Tokyo University of Science; Ibaraki Japan
| | - Ryo Kosaka
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST)
| | - Keiji Oi
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Tomohiro Mizuno
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
| | - Osamu Maruyama
- Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST)
| | - Hirokuni Arai
- Department of Cardiovascular Surgery; Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences
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