PLATELET-FUNCTION AFTER TOTAL ARTIFICIAL-HEART REPLACEMENT - CLINICAL-APPLICATION AND EXPERIMENT

Clinical application of artificial blood pumps for mechanical circulat ory support has been hampered by thromboembolic events. The underlying mechanisms are complicated and may differ from patient to patient. Be cause the calf is commonly used for artificial heart studies, the obje ct was to determine the value of data gained in an animal model. To th is end, the average of 10 calf experiments was compared with three cli nical applications of an orthotopically implanted total artificial hea rt in patients with terminal heart failure. Platelet reactivity was in vestigated in vitro by collagen-induced whole blood aggregometry, radi oimmunoassay methods, and scanning electron microscopy over a 10-day p eriod. An analogous periodicity of platelet function was found in huma n and animal recipients. Improvement of platelet function preceded tha t of platelet counts in the early postoperative phase. Exaggerated res ponses to aggregative agents were observed at days 3 and 7. On the bas is of our data, we believe that we can comment about the prospective c ourse of the function and number of human platelets, which may contrib ute to the identification of critical phases of such treatment, during total artificial heart replacement.