Abstract
We developed an optical thrombus sensor for a monopivot extracorporeal centrifugal blood pump. In this study, we investigated its quantitative performance for thrombus detection in acute animal experiments of left ventricular assist using the pump on pathogen-free pigs. Optical fibers were set in the driver unit of the pump. The incident light at the near-infrared wavelength of 810 nm was aimed at the pivot bearing, and the resulting scattered light was guided to the optical fibers. The detected signal was analyzed to obtain the thrombus formation level. As a result, real-time and quantitative monitoring of the thrombus surface area on the pivot bearing was achieved with an accuracy of 3.6 ± 2.3 mm2. In addition, the sensing method using the near-infrared light was not influenced by changes in the oxygen saturation and the hematocrit. It is expected that the developed sensor will be useful for optimal anticoagulation management for long-term extracorporeal circulation therapies.
Highlights
Thrombus formation remains a significant issue for patients requiring extracorporeal mechanical circulatory support (MCS) devices for therapies such as percutaneous cardiopulmonary support (PCPS), extracorporeal membrane oxygenation (ECMO), and as left and right ventricular assist devices (LVADs and RVADs) [1,2]
The light guided by a plastic optical fiber (POF) with a core diameter of 200 μm is totally reflected in a vertical direction by a prism attached at the exit of the fiber, and the light is collimated by a hemisphere lens to aim it toward the center of the SUS ball
The light at a wavelength that is strongly absorbed by hemoglobin responds to thrombus formation, because an optical change mainly occurs due to changes in the red blood cells (RBCs) density surrounding the clotting area
Summary
Thrombus formation remains a significant issue for patients requiring extracorporeal mechanical circulatory support (MCS) devices for therapies such as percutaneous cardiopulmonary support (PCPS), extracorporeal membrane oxygenation (ECMO), and as left and right ventricular assist devices (LVADs and RVADs) [1,2] These extracorporeal MCS therapies have recently shown great potential for acute use and mid-term use from several weeks to months as a bridge to an implantable artificial heart (bridge to bridge), bridge to transplantation, and bridge to recovery from severe cardiac failure [3,4,5]. Methods of real-time quantitative monitoring for the anticoagulation degree [8] or assessment of the blood-clotting reaction in MCS circuits [9,10,11,12,13] have been studied and developed These methods are not yet suitable for practical clinical use, because they cannot be assembled where the thrombus formation occurs in MCS devices during actual clinical use. Some ultrasound techniques to detect thrombi in flowing vessels have been used in clinical applications [14,15], our motivation is to achieve the earliest detection of a thrombus inside MCS devices before the thrombus is projected into a patient
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