Abstract:
:The existence of acquired von Willebrand syndrome (AVWS) in patients with continuous flow left ventricular assist devices (LVADs) is well documented and has been verified by numerous investigators. AVWS has not been observed to occur in pulsatile devices such as the SynCardia total artificial heart (TAH), the HeartMate XVE, and the Thoratec pulsatile ventricular assist device (PVAD) used as a single pump. AVWS can also occur in patients with aortic stenosis, ventricular septal defect, mitral stenosis, and patent ductus arteriosus. It has been experimentally verified that supraphysiologic shear stress that occurs under these conditions can cleave the von Willebrand molecule, but the critical magnitude of stress and duration is unclear. Limited experimental results demonstrate that shear stresses as low as 5 Pa (50 dyne/cm2 ) can cause cleavage. Stresses in current centrifugal pumps can be as high as two orders of magnitude greater than this value. Pulsatile LVADs have stresses almost two orders of magnitude less than continuous flow LVADs. In order to improve continuous flow LVADs, the challenge for designers is to first determine the magnitude and duration of stress that is causing AVWS and then, if possible, design a pump below these stresses.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Rosenberg G,Siedlecki CA,Jhun CS,Weiss WJ,Manning K,Deutsch S,Pierce Wdoi
10.1111/aor.13291subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1119-1124issue
12eissn
0160-564Xissn
1525-1594journal_volume
42pub_type
杂志文章,评审abstract::Ventricular assist devices have been shown to be effective in advanced heart failure selected patients. They often have borderline end-organ function, what facilitates organ dysfunction. Liver failure is difficult to manage and leads to increased morbidity and mortality. We report a case of ductular cholestasis, an un...
journal_title:Artificial organs
pub_type: 杂志文章
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journal_title:Artificial organs
pub_type: 杂志文章
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journal_title:Artificial organs
pub_type: 杂志文章,评审
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journal_title:Artificial organs
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journal_title:Artificial organs
pub_type: 杂志文章
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journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:1998-08-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-07-01 00:00:00
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pub_type: 杂志文章
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journal_title:Artificial organs
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更新日期:2014-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2003-11-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1996.tb00661.x
更新日期:1996-11-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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更新日期:1998-05-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1992.tb00558.x
更新日期:1992-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/aor.13626
更新日期:2020-06-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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