Platelet activation with the Aeson Bioprosthetic Total Artificial Heart: insight from aspirin treatment and outcomes

Abstract

Introduction: The Aeson bioprosthetic total artificial heart (ATAH) is a pulsatile and autoregulated device. The aim of this study was to evaluate the level of platelet activation secondary to ATAH implantation. Methods: We examined the level of platelet activation markers in adult patients receiving ATAH support (n=16) during clinical follow up by quantifying sPselectin (sPsel) and sCD40L in plasma. Results: The cumulative duration of ATAH support was 3587 days. Before implantation, sCD40L was 2684.6 pg/mL (954.0;16706.1) and remained steady after implantation [3305.8 pg/mL (1234.2;12327.5), 3300.5 pg/mL (1041.5;8370.1), and 2560.0 pg/mL (1325.5;14039.5), respectively, at <3 months, 3/6 months and >6 months; non-significant difference along time-period]. sPsel was 33997.0 pg/mL (16019.6;73377.6) and remained steady after implantation [33580.1 pg/mL (13979.8;53395.2), 33204.9 pg/mL (15332.6;67263.4), and 34684.5 pg/mL (14084.9;49206.0), respectively, at <3 months, 3/6 months and >6 months; non-significant difference along time-period]. Levels sPsel and sCD40L analysed according to aspirin or heparin use did not change. Finally, no relation existed between pericardial effusion and aspirin use according to timing of aspirin start and drain removal. Conclusions: We demonstrated that ATAH does not induce significant platelet activation. Absence of relationship between aspirin and platelet activation levels or pericardial effusion may support potential for withdrawal of antiplatelet therapy after ATAH implantation in the future.