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#GRANTWINNERS: identified new mechanism involved in thrombus formation in LVAD device

23 July 2019
Research

Thanks to a funding from Fondazione Cariplo for young researchers, it was possible to study the mechanisms underlying thrombus formation in patients undergoing LVAD implantation. The project manager is Filippo Consolo, Biomedical Engineer and Researcher at the Faculty of Medicine and Surgery UniSR.

Their study focused on thromboembolic complications in LVAD patients, i.e. those complications that develop due to thrombus formation (accumulation of platelets, red blood cells and/or white blood cells) inside the pump. The thrombi hamper or prevent the normal operation of the device; these events are characterized by a high mortality rate.

Filippo Consolo states:

By analyzing the data in the literature we have observed that thromboembolic complications in LVAD patients often occur as a consequence of intraventricular thrombus formation, i.e. the thrombus is originally formed inside the ventricle and from there it moves inside the pump. The fact that in these patients the thrombus generates precisely in the anatomical implantation site of the device has led us to suppose the presence of peculiar mechanisms (not entirely known) in that district, that favor the onset of the pathology”.

The funded project set out to analyze the cellular mechanisms of interaction between platelets and the endothelium (internal cell lining) of the ventricle. The multidisciplinary team identified a possible “triggering” mechanism of intraventricular thrombosis, due to a combined effect of LVAD-mediated platelet activation and cytokine-mediated inflammatory endothelium activation.

To date, the antithrombotic therapy used in LVAD patients does not contemplate these phenomena and it is not able to prevent them. Achieving this goal could lead to a significant reduction in the rate of thrombo-embolic complications – often deadly or otherwise highly disabling. Reducing complications is therefore essential in order to increase patients’ life expectancy”.

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