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J Thorac Cardiovasc Surg 2009;137:736-741
© 2009 The American Association for Thoracic Surgery

Cardiopulmonary Support

Evaluation of platelet activation in patients supported by the Jarvik 2000^_* high–rotational speed impeller ventricular assist device

Christoph Löffler, MD^a,, Andreas Straub, MD^c,,_*, Nicole Bassler, BA^c,, Katharina Pernice, MD^b, Friedhelm Beyersdorf, MD^b, Christoph Bode, MD^a, Michael P. Siegenthaler, MD^b,,||, Karlheinz Peter, MD^c,||

^a Department of Cardiology and Angiology, University Hospital, Albert-Ludwigs-University, Freiburg, Germany
^b Department of Cardiovascular Surgery, University Hospital, Albert-Ludwigs-University, Freiburg, Germany
^c Baker Heart Research Institute, Melbourne, Australia

Received for publication May 6, 2008; revisions received August 16, 2008; accepted for publication September 6, 2008.

^_* Address for reprints: Andreas Straub, MD, Centre for Thrombosis and Myocardial Infarction, Baker Heart Research Institute, PO Box 6492 St Kilda Rd Central, Melbourne, Victoria 8008, Australia. (Email: Andreas.Straub{at}baker.edu.au).

Objective: The Jarvik 2000 (Jarvik Heart, Inc, New York, NY) is a thumb-sized high-speed impeller pump that is used as a ventricular assist device in patients with terminal heart failure. Because the Jarvik 2000 is designed for long-term use, it is a central question whether the mechanical forces inside the pump affect blood components. This study evaluated the potential association of the high rotational speed of the Jarvik 2000 with platelet activation, which may result in thromboembolic events.

Methods: The study group comprised patients with terminal heart failure who were supported with the Jarvik 2000. All were men and received 100 mg aspirin daily. In 8 patients, soluble platelet activation markers (P-selectin and sCD40L), platelet counts, and hemolysis markers (haptoglobin and lactate dehydrogenase levels) were determined. In 5 patients, P-selectin expression and platelet receptor glycoprotein IIb/IIIa activation were determined with flow cytometry and compared with a control group of 5 healthy men. Platelet activation was measured at various rotational device speeds.

Results: After Jarvik 2000 implantation, increased hemolysis was observed, but platelet activation markers and platelet counts were not affected. Increased rotational speed (8000 to 12,000 rpm) of the device also did not result in increased platelet activation.

Conclusion: The Jarvik 2000 was not associated with detectable platelet activation, despite high rotational impeller speeds.