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A new hypothesis on the mechanism of calcification formed on a blood-contacted polymer surface

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Abstract

Calcification on a blood-contacting polymer surface in an artificial heart is one of the most serious problems. Recently, we maintained a goat with a total artificial heart (AH) for 532 days without systemic anticoagulation. Sactype blood pumps coated with segmented polyurethane and incorporating jellyfish valves, thin polymer membrane valves, were used in the experiment. The pump was exchanged for a new one on the 312th day on the left side and the 414th day on the right side. They were analyzed with a scanning electron microscope (SEM) and an X-ray microanalyzer. The valve membrane after 312 days of pumping revealed plastic deformation expanding toward upstream between the spokes by creep fatigue with blood pressure difference when the valve closed. Calcification on the membrane was concentrated in the limited portions that received a strong stretching force: the upstream side of the membrane between the spokes and downstream side of the membrane on the spokes. Slight or no calcification was observed on the opposite side of the membrane that received a compression force, and no calcification was found on nonmoving parts such as the center of the membrane and spokes. A new hypothesis on the mechanism of calcification at the portion that received repeated stretching force was raised. The repeated stretching force would extend the polymer membrane, causing some loosening between polymer molecules and generating microgaps. The blood protein and phospholipid would invade into these microgaps, which would then attract Ca ions followed by phosphate ions to make their complexation. The hypothesis could well explain the calcification phenomena on a blood-contacting polymer surface, and gave a good clue on how to protect from calcification.

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References

  1. Atsumi K, Hori M, Ikeda S, Sakurai Y, Fujimori Y, Kimoto S. Artificial heart incorporated in the chest. Trans Am Soc Artif Intern Organs 1963;9:292–298

    PubMed  Google Scholar 

  2. Imachi K, Chinzei T, Abe Y, Isoyama T, Mochizuki S, Saito I, Ono T, Karita T, Matsuura H, Kouno A, Mabuchi K, Fuhimasa I, Atsumi K. Implantable total artificial heart-history and present status at the University of Tokyo. J Artif Organs 1999;2:13–23

    Google Scholar 

  3. Atsumi K, Fujimasa I, Imachi K, Nakajima M, Tsukagoshi S, Mabuchi K, Motomura K, Kouno A, Ono T, Miyamoto A, Takido N, Inou N. Long-term heart substitution with an artificial heart in goats. ASAIO J 1985;8:155–165

    Google Scholar 

  4. Imachi K, Fujimasa I, Mabuchi K, Chinnzei T, Abe Y, Maeda K, Imanishi K, Kouno A, Ono T, Atsumi K. A newly designed jellyfish valve for an artificial heart blood pump. Trans Am Soc Artif Intern Organs 1988;34:726–728

    Google Scholar 

  5. Imachi K, Mabuchi K, Chinnzei T, Abe Y, Imanishi K, Yonezawa T, Maeda K, Suzukawa M, Kouno A, Ono T, Fujimasa I, Atsumi K. In vitro and in vivo evaluation of a jellyfish valve for practical use. Trans Am Soc Artif Intern Organs 1989;35:298–301

    Google Scholar 

  6. Imachi K, Mabuchi K, Chinnzei T, Abe Y, Imanishi K, Suzukawa M, Yonezawa T, Kouno A, Ono T, Nozawa H, Atsumi K, Fujimasa I. Blood compatibility of the jellyfish valve without anticoagulant. Trans Am Soc Artif Intern Organs 1991;37:220–222

    Google Scholar 

  7. Imachi K, Mabuchi K, Chinnzei T, Abe Y, Imanishi K, Yonezawa T, Kouno A, Ono T, Nozawa H, Isoyama T, Atsumi K, Fujimasa I. Fabrication of a jellyfish valve for use in an artificial heart. ASAIO J 1992;38:237–242

    Google Scholar 

  8. Imachi K, Mabuchi K, Chinnzei T, Abe Y, Imanishi K, Yonezawa T, Nozawa H, Isoyama T, Kouno A, Ono T, Atsumi K, Fujimasa I. The jellyfish valve: a polymer membrane valve for the artificial heart. In: Akutsu T, Koyanagi H (eds) Heart replacement: artificial heart 4. Tokyo: Springer-Verlag, 1993;41–44

    Google Scholar 

  9. Abe Y, Chinzei T, Isoyama T, Mabuchi K, Baba K, Matsuura H, Kouno A, Ono T, Mochizuki S, SonYP, Imanishi K, Atsumi K, Fujimasa I, Imachi K. Over 500 days survival of total artificial heart goat with 1/R control. In: Akutsu T, Koyanagi H (eds) Heart replacement: artificial heart 6. Tokyo, Springer-Verlag, 1998;34–38

    Google Scholar 

  10. Imachi K, Fujimasa I, Miyake H, Takido N, Nakajima M, Motomura K, Kouno A, Ono T, Atsumi K. Evaluation of antithrombogenicity, durability, and blood compatibility of an artificial heart system for more than 100 days. Artific Organs 1981; 5(Suppl):423–429

    Google Scholar 

  11. Dahl LK. A simple and sensitive histochemical method for calcium. Proc Soc Exp Biol Med 1952;80:474–479

    PubMed  Google Scholar 

  12. Coleman DI, Andrade JD, Kolff WJ. Calcification of long term artificial heart implants. ASAIO Abstr 1979;8:23

    Google Scholar 

  13. Rennekamp F, Affeld K, Clevert HD, Frank J, Gerlack K, Grosse-Siestrup C, Hennig E, Keilbach H, Krautzberger W, Kuhlmann F, Lemm W, Mohnhaupt A, Unger V, Weidemann H, Zartnack F, Bucherl ES. Long time results with seamless bloodpumps out of polyurethanes for the replacement of the heart. Proc Eur Soc Artif Organs 1979;6:94–98

    Google Scholar 

  14. Imachi K. Long-term use of artificial heat without anticoagulant. In: Nose Y, Kjellstrand C, Ivanovich P (eds) Progress in artificial organs 1985. Cleverland: ISAO Press, 1986;319–326

    Google Scholar 

  15. Coleman DI, Lin D, Kessler T, Andrade JD. Calcification of nontextured implantable blood pump. Trans Am Soc Artif Intern Organs 1981;27:97–104

    PubMed  Google Scholar 

  16. Pierce WS, Donachy JH, Rosenberg G. Calcification inside artificial heart: inhibition by wafarin-sodium. Science 1980;208:601–602

    PubMed  Google Scholar 

  17. Vasku J. Total artificial heart research in Czechoslovakia: pathophysiological evaluation of long-term experiments performed from 1979 to 1985. In: Akutsu T (ed) Artificial heart 1. Tokyo: Springer-Verlag, 1986;161–179

    Google Scholar 

  18. Wisman CB, Pierce WS, Donachy JH, Pae WE, Myers JL, Prophet GA. A polyurethane trileaflet cardiac valve prosthesis: in vitro and in vivo studies. Trans Am Soc Artif Intern Organs 1982;28:164–168

    PubMed  Google Scholar 

  19. Fujimasa I, Imachi K, Nakajima M, Mabuchi K, Tsukagoshi S, Kouno A, Ono T, Takido N, Motomura K, Chinzei T, Abe Y, Atsumi K. Pathological study of a total artificial heart in a goat that survived for 344 days. In Nose Y, Kjellstrand C, Ivanovich P (eds) Progress in artificial organs-1985. Cleveland: ISAO Press, 1986; 345–353

    Google Scholar 

  20. Imachi K. Discussion in Biomaterial Session. In: Bucherl ES (ed) Proceedings Second World Symposium Artificial Heart, Vieweg, Braunschweig, 1986;27–35

    Google Scholar 

  21. Harasaki H, Moritz A, Uchida N, Chen J-F, McMahon JT, Richards TM, Smith WA, Murabayashi S, Kambic HE, Kiraly RJ, Nose Y. Initiation and growth of calcification in a polyurethanecoated blood pump. Trans Am Soc Artif Intern Organs 1987; 33:643–649

    Google Scholar 

  22. Vasku J. Change in total artificial heart driving diaphragms after long-term pumping. In: Akutsu T, Koyanagi H (eds) Heart replacement: artificial heart 5. Tokyo. Springer-Verlag, 1996;53–64

    Google Scholar 

  23. Imachi K, Abe Y, Chinzei T, Mabuchi K, Baba K, Matsuura H, Kouno A, Ono T, Mochizuki S, Son Y, Imanishi K, Fujimasa I. Calcification and thrombus formation on polymer surface of an artificial heart. In: Akutsu T, Koyanagi H (eds) Heart replacement: artificial heart 6. Tokyo:Springer-Verlag, 1998;110–115

    Google Scholar 

  24. Iwasaki K, Umezu M, Kobayashi Y, Imachi K, Fujimoto T. Development of a durable polymer valve based on finite element analysis. Proceedings of 4th Asia-Pacific Conference on Medical and Biological Engineering 1999;252

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Authors and Affiliations

  1. Department of Biomedical Engineering, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo Bunkyo-ku, 113-0033, Tokyo, Japan

    Kou Imachi PhD, Yusuke Abe MD, PhD, Tatsuo Karita MD, PhD, Shuichi Mochizuki MD, PhD, Yam-pin Son MD, PhD, Itsuro Saito PhD, Akimasa Kouno BS & Toshiya Ono BS

  2. Research Center for Advanced Science and Technology, University of Tokyo, Tokyo, Japan

    Tsuneo Chinzei MD, PhD

  3. Center for Collaborative Research, University of Tokyo, Tokyo, Japan

    Kunihiko Mabuchi MD, PhD

  4. National Graduate Institute for Policy Studies, Tokyo, Japan

    Hiroyuki Matsuura MD, PhD

  5. Department of Mechanical Engineering, Waseda University, Tokyo, Japan

    Kiyotaka Iwasaki MsEng

Authors
  1. Kou Imachi PhD
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  2. Tsuneo Chinzei MD, PhD
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  3. Yusuke Abe MD, PhD
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  4. Kunihiko Mabuchi MD, PhD
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  5. Hiroyuki Matsuura MD, PhD
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  6. Tatsuo Karita MD, PhD
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  7. Kiyotaka Iwasaki MsEng
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  8. Shuichi Mochizuki MD, PhD
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  9. Yam-pin Son MD, PhD
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  10. Itsuro Saito PhD
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  11. Akimasa Kouno BS
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  12. Toshiya Ono BS
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Corresponding author

Correspondence to Kou Imachi PhD.

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Imachi, K., Chinzei, T., Abe, Y. et al. A new hypothesis on the mechanism of calcification formed on a blood-contacted polymer surface. J Artif Organs 4, 74–82 (2001). https://doi.org/10.1007/BF01235840

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  • DOI: https://doi.org/10.1007/BF01235840

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