Platelet Activation in the Gyro C1E3 Centrifugal Pump: Comparison with the Terumo Capiox and the Nikkiso HPM‐15

Abstract

The Gyro C1E3 was developed as a cardiopulmonary bypass pump incorporating the sealless double pivot bearing system. In this study, we evaluated platelet activation induced by the Gyro C1E3 in vitro and in comparison to that of other centrifugal pumps. Rates of increase (RI) for beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) in the Gyro C1E3 were calculated from in vitro data and compared with the rate of increase in the Capiox (Terumo) and HPM-15 (Nikkiso) pumps. Fresh human blood was used, and a flow of 5.0 L/min with a DeltaP (pressure difference between the outlet and inlet of the pump) of 100 mm Hg employed. RI = Deltabeta-TG/DeltaN and DeltaPF4/DeltaN were used where Deltabeta-TG is the increase in beta-TG, DeltaPF4 is the increase in PF4, and DeltaN is the increase in the passing number and where N = Qt/V (t = time, V = priming volume, and Q = flow rate). The mean RI for beta-TG was 0.26 +/- 0. 05 in the Gyro C1E3, 0.20 +/- 0.07 in the Capiox, and 0.15 +/- 0.02 in the HPM-15. The mean RI for PF4 was 0.15 +/- 0.03 in the Gyro C1E3, 0.12 +/- 0.05 in the Capiox, and 0.09 +/- 0.04 in the HPM-15. While there was no difference in RI for beta-TG and PF4 between the Gyro C1E3 and Capiox, RI for beta-TG and PF4 were significantly higher in the Gyro C1E3 than in the HPM-15 (p = 0.006 and 0.029). In vitro evaluation using RI for beta-TG and PF4 showed platelet damage caused by the Gyro C1E3 and the Capiox to be nearly equal while the HPM-15 was less traumatic to platelets than the Gyro C1E3.

Towards Non-thrombogenic Performance of Blood Recirculating Devices

“…Regretfully, very few data on flow-induced thrombogenic aspects are currently available. Several approaches for studying device-induced thrombogenicity are in progress by few groups 51,53,56. Jesty and Bluestein51 have developed an innovative Platelet Activity State (PAS) assay, facilitating near real time measurements of the thrombogenic potential induced by flow in devices.…”

Thrombus and Stroke

“…Acute thrombi are rich in platelets (white clots) as opposed to clots associated with fl ow stasis, such as venous thrombi or pulmonary emboli, which are rich in erythrocytes (red clots). An ex vivo fl ow chamber system used to test platelet aggregation in x-xxxx_6x9_Tight_New_Ch02_R1_DK965X samples of human blood with different coronary stent designs and different pharmaceutical regimens found evidence that supports the use of dual antiplatelet therapy (aspirin and clopidogrel) over aspirin alone ( 146 ). This is supported by the observation that anticoagulants such as heparin and warfarin are effective treatments against this disease.…”