Careful device construction with smooth, seamless surfaces and the development of new antithrombogenic materials are critical to preventing clotting in artificial heart devices.
Demands vigilance at device junctions in current artificial hearts; leaves open prospective validation of novel antithrombogenic materials.
The clotting problem inside the artificial heart device is one of the major obstacles standing in the way of a successful long‐term implantation of the artificial heart. To date, there have been two artificial heart devices used clinically. One is the auxiliary ventricle and the other is the left heart bypass pump. The former is for permanent implantation and the other is implanted only temporarily. Several experimental results which had contributed to the successful implantation of the auxiliary ventricle are described, especially from the standpoint of avoiding the clotting inside the device. Basic experiments with the left heart bypass pump are also described. The valves are the foremost problem and the next is the junction of the two materials. It is ideal to have a smooth, seamless surface made entirely of one material. It is also necessary to have a flow pattern analysis inside the artificial heart device as well as a clotting pattern analysis. Since the pump oxygenator and heparinization are involved in the procedure, the clotting problems in the total heart experiment are usually less than in the left heart bypass experiments. Our most urgent requirement is the development of new antithrombogenic material. However, even with our present material a large part of the clotting could be avoided if the heart is carefully constructed.
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Yukihiko Nosé (1967) studied this question.
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