Effect of shear rates on protein adsorption in the total artificial heart.
Plasma protein adsorption is the first event in blood-material interaction and influences subsequent platelet adhesion and thrombus formation. Thromboembolic events are strongly influenced by surface characteristics of materials and fluid dynamics inside the blood pump. In vitro flow visualization, and an animal experiment with a moving actuator total artificial heart (TAH), were performed to investigate fluid dynamic effects on protein adsorption. The different levels of shear rate inside the ventricle were determined by considering the direction of opening of the four heart valves in the implanted TAH, and the visualized flow patterns as well. Each ventricle of the explanted TAH was cut into 12 segments according to the shear rate level. The adsorbed protein on each segment was quantified using an ELISA method after soaking in 2% (w/v) SDS/PBS for 2 days. Adsorbed protein layer thicknesses were measured by the immunogold method under transmission electron microscopy. Scanning electron microscopic observation showed that the right ventricle, immobilized with albumin, displayed different degrees of platelet adhesion on each segment, whereas the left ventricle, coated with polythyleneoxide-sulfonate, indicated nearly the same platelet adhesion behavior, regardless of shear rates. The surface concentrations of adsorbed proteins in the low shear rate region are higher than those in the high shear region, which was confirmed statistically.