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ULTRASTRUCTURAL ANALYSES OF BLOOD-INTERFACING LININGS FORMED WITHIN PARTIAL ARTIFICIAL HEARTS OR ABDOMINAL LEFT VENTRICULAR ASSIST DEVICES: A QUALITATIVE SCHEME FOR HUMAN PSEUDONEOINTIMAL ACCRETION KINETICS

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PMC
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  • Articles
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  • Biology

Abstract

Following each of 21 clinical trials with the partial artificial heart or abdominal left ventricular assist device (ALVAD), we have examined the blood-interfacing human pseudoneointimal (PNI) linings formed on the fibril-flocked pumping surface by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The salient results of these ultrastructural analyses can be summarized: (1) early PNI accretion kinetics (< 24 hrs) involve plasma protein adsorption, entrapment of erythrocytes, platelets, lymphocytes, numerous neutrophils and macrophages, and the deposition of fibrin within fibril flock interstices (TEM); (2) the surface (< 24 hrs) consists of interconnected fibrin strands (SEM); (3) later PNI accretion kinetics (1-6 days) involve the formation of alternating cellular and fibrin layers (TEM); (4) the surface (1-6 days) consists of cellular aggregates (inter-membrane distances of 340 Å) simulating an endothelial interface (SEM, TEM).

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