European Journal of Cardio-Thoracic Surgery, Vol 4, 671-674, Copyright © 1990 by European Association for Cardio-thoracic Surgery
Scanning electron microscopy evaluation of the Abiomed 5000 ventricular support system after clinical biventricular assistance
AS Bohle, HH Sievers and A Bernhard
Department of Cardiovascular Surgery, Christian Albrechts-University, Kiel, FRG.
Twenty-nine days after implantation of an Abiomed 5000 biventricular
support system for otherwise intractable end-stage cardiomyopathy, the
inner surfaces of the device were examined by means of scanning electron
microscopy (SEM). SEM showed clean surfaces inside the blood sacs, with
only rare fibrin deposits. There were platelet adhesions on the ventricular
side of the artificial atrioventricular valves; no deposits were on the
opposite side. Structural deterioration of the closing edge of the
artificial valves could be seen. The tubing system was likewise covered by
a uniform deposition of single platelets with no major thrombus formation.
Postmortem examination of the patient, on the other hand, revealed gross
thrombus formation inside both atria at the cannulation sites, despite
efficient anticoagulation. We conclude that the Abiomed 5000 per se is
unlikely to be the site of major thrombus formation leading to subsequent
embolization after 660 h implantation. However, the structural integrity of
the adapting areas of the leaflets may become a point of concern. Further
research is necessary to improve the atrial cannulation technique in order
to prevent the atrial thrombus formation demonstrated as the source of
systemic embolization.
