David M Smadja1, Sophie Susen2, Antoine Rauch2, Bernard Cholley3, Christian Latrémouille4, Daniel Duveau5, Luca Zilberstein6, Denis Méléard7, Marie-Fazia Boughenou7, Eric Van Belle8, Pascale Gaussem9, Antoine Capel10, Piet Jansen10, Alain Carpentier11. 1. AP-HP, European Georges Pompidou Hospital, Hematology Department, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm UMR-S1140, Paris, France. Electronic address: david.smadja@aphp.fr. 2. Hematology Department, University Hospital, Inserm UMR-S 1176, Lille-II-University, Lille, France. 3. Université Paris Descartes, Sorbonne Paris Cité, Paris, France; AP-HP, European Georges Pompidou Hospital, Anesthesia and Intensive Care Department, Paris, France. 4. Université Paris Descartes, Sorbonne Paris Cité, Paris, France; AP-HP, European Georges Pompidou Hospital, Cardiovascular Surgery Department and Biosurgical Research Laboratory, Paris, France. 5. Cardiovascular Surgery Department, University Hospital Guillaume and René Laennec, Nantes, France. 6. Alfort National Veterinary School, Maisons Alfort, France. 7. AP-HP, European Georges Pompidou Hospital, Anesthesia and Intensive Care Department, Paris, France. 8. Cardiology Department, University Hospital, Inserm UMR-S 1176, Lille-II-University, Lille, France. 9. AP-HP, European Georges Pompidou Hospital, Hematology Department, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Inserm UMR-S1140, Paris, France. 10. Carmat SA, Vélizy-Villacoublay, France. 11. AP-HP, European Georges Pompidou Hospital, Cardiovascular Surgery Department and Biosurgical Research Laboratory, Paris, France.
Abstract
OBJECTIVES: To determine hemostasis perturbations, including von Willebrand factor (VWF) multimers, after implantation of a new bioprosthetic and pulsatile total artificial heart (TAH). DESIGN: Preclinical study SETTING: Single-center biosurgical research laboratory. PARTICIPANTS: Female Charolais calves, 2-to-6 months old, weighing 102-to-122 kg. INTERVENTIONS: Surgical implantation of TAH through a mid-sternotomy approach. MEASUREMENTS AND MAIN RESULTS: Four of 12 calves had a support duration of several days (4, 4, 8, and 10 days), allowing for the exploration of early steps of hemostasis parameters, including prothrombin time; coagulation factor levels (II, V, VII+X, and fibrinogen); and platelet count. Multimeric analysis of VWF was performed to detect a potential loss of high-molecular weight (HMW) multimers, as previously described for continuous flow rotary blood pumps. Despite the absence of anticoagulant treatment administered in the postoperative phase, no signs of coagulation activation were detected. Indeed, after an immediate postsurgery decrease of prothrombin time, platelet count, and coagulation factor levels, most parameters returned to baseline values. HMW multimers of VWF remained stable either after initiation or during days of support. CONCLUSIONS: Coagulation parameters and platelet count recovery in the postoperative phase of the Carmat TAH (Camat SA, Velizy Villacoublay Cedex, France) implantation in calves, in the absence of anticoagulant treatment and associated with the absence of decrease in HMW multimers of VWF, is in line with early hemocompatibility that is currently being validated in human clinical studies.
OBJECTIVES: To determine hemostasis perturbations, including von Willebrand factor (VWF) multimers, after implantation of a new bioprosthetic and pulsatile total artificial heart (TAH). DESIGN: Preclinical study SETTING: Single-center biosurgical research laboratory. PARTICIPANTS: Female Charolais calves, 2-to-6 months old, weighing 102-to-122 kg. INTERVENTIONS: Surgical implantation of TAH through a mid-sternotomy approach. MEASUREMENTS AND MAIN RESULTS: Four of 12 calves had a support duration of several days (4, 4, 8, and 10 days), allowing for the exploration of early steps of hemostasis parameters, including prothrombin time; coagulation factor levels (II, V, VII+X, and fibrinogen); and platelet count. Multimeric analysis of VWF was performed to detect a potential loss of high-molecular weight (HMW) multimers, as previously described for continuous flow rotary blood pumps. Despite the absence of anticoagulant treatment administered in the postoperative phase, no signs of coagulation activation were detected. Indeed, after an immediate postsurgery decrease of prothrombin time, platelet count, and coagulation factor levels, most parameters returned to baseline values. HMW multimers of VWF remained stable either after initiation or during days of support. CONCLUSIONS: Coagulation parameters and platelet count recovery in the postoperative phase of the Carmat TAH (Camat SA, Velizy Villacoublay Cedex, France) implantation in calves, in the absence of anticoagulant treatment and associated with the absence of decrease in HMW multimers of VWF, is in line with early hemocompatibility that is currently being validated in human clinical studies.
Authors: Annemijn Vis; Maziar Arfaee; Husain Khambati; Mark S Slaughter; Jan F Gummert; Johannes T B Overvelde; Jolanda Kluin Journal: Nat Rev Cardiol Date: 2022-06-06 Impact factor: 32.419
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Authors: Ulysse Richez; Hector De Castilla; Coralie L Guerin; Nicolas Gendron; Giulia Luraghi; Marc Grimme; Wei Wu; Myriam Taverna; Piet Jansen; Christian Latremouille; Francesco Migliavacca; Gabriele Dubini; Antoine Capel; Alain Carpentier; David M Smadja Journal: Heliyon Date: 2019-12-08