The Effect of Flow Field on the Initial Formation of Thrombus in Ventricular Assist Devices

Abstract

Thrombosis is the main reason for the failure of ventricular assist devices (VADs). It has been acknowledged that the platelet activation induced by the nonphysiological blood flow leads to the increased thrombotic risk. However, due to the complicated influence of the VADs’ flow field and the difficulty in real‐time in situ observation, the mechanisms and process of thrombus formation in VADs remain unclear. In this work, the process of thrombus formation in VADs in vitro experiments is observed. The thrombus is found to form on the middle of the inlet guide vanes first and it is mainly caused by the immediate activation of platelets induced by the high shear rate of the flow field around the vanes and also affected by the rotation of the impeller. Then, subsequent thrombus is found in the tail of guide vanes and around the axle journal, where the blood flow is stagnated and the platelets are activated by the accumulated bioagonists. These findings clarify that the thrombus formed on the inlet guide vanes and the axle journal are dominated by two different mechanisms. This work provides unique insights into the initial formation of the thrombus on VADs and helps to reduce the thrombotic risk.