THE CLEVELAND CLINIC CORAIDETM BLOOD PUMP WITHOUT ANTICOAGULATION THERAPY

Abstract

Purpose: The Cleveland Clinic CorAideTM left ventricular assist system is based on a small implantable continuous flow centrifugal pump designed for long term circulatory support (5–10 years). From August to November 2000, we performed a series of calf in vivo studies to evaluate the biocompatibility effects of discontinuation of intravenous heparin anticoagulation therapy. Methods: Chronic CorAideTM blood pump implantation was performed in 4 calves (89.5 ± 4.9 kg). The inflow cannula was inserted into the left ventricular apex, and the outflow graft was anastomosed to the aorta without cardiopulmonary bypass. In all 4 calves, CorAideTM blood pump was positioned in the left chest cavity. During the early postoperative periods (2–7 days), intravenous heparin was used to maintain the activated clotting time values at approximately 1.2 times baseline. Heparin administration was then discontinued with no other anticoagulants or antiplatelet drugs given for the duration of the experiments. All animals were electively sacrificed and autopsy was performed at a mean 29 days postoperatively. Results: There was no incidence of mechanical failure, bleeding, or device infection. Hemolysis occurred in one calf due to outflow graft stenosis. The blood pump surfaces were clean in all 4 calves. Conclusion: These results suggest that the CorAideTM blood pump can be safely run with minimal or no anticoagulants. We will conduct 90 day duration studies to further document the use of the CorAideTM blood pump without anticoagulants.