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7 záznamů v Medvik Filtry

Článek online

Bioprosthetic Total Artificial Heart in Autoregulated Mode Is Biologically Hemocompatible: Insights for Multimers of von Willebrand Factor

Poitier, Bastien
Autor Poitier, Bastien Université de Paris, Innovative Therapies in Hemostasis, INSERM, F-75006 Paris, France (B.P., A.C., C.L.) Cardiac Surgery Department and Biosurgical Research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, France (B.P., A.C., C.L.) Carmat SAS, Velizy-Villacoublay, France (B.P., U.R., M.G., A.C., P.J.)
Chocron, Richard
Autor Chocron, Richard ORCID Université de Paris, PARCC, INSERM, F-75015 Paris, France, Emergency department, AP-HP, Georges Pompidou European Hospital, France (R.C.)
Peronino, Christophe
Autor Peronino, Christophe Université de Paris, Innovative Therapies in Hemostasis, INSERM, F-75006 Paris, France, Hematology department and Biosurgical Research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, France (C.P., A.P., N.R., U.R., N.G., J.B., J.R., D.M.S.)
Philippe, Aurélien
Autor Philippe, Aurélien Université de Paris, Innovative Therapies in Hemostasis, INSERM, F-75006 Paris, France, Hematology department and Biosurgical Research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, France (C.P., A.P., N.R., U.R., N.G., J.B., J.R., D.M.S.)
Pya, Yuri
Autor Pya, Yuri National Research Cardiac, Surgery Center, Nur-Sultan, Kazakhstan (Y.P., M.B.)
Rivet, Nadia
Autor Rivet, Nadia Université de Paris, Innovative Therapies in Hemostasis, INSERM, F-75006 Paris, France, Hematology department and Biosurgical Research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, France (C.P., A.P., N.R., U.R., N.G., J.B., J.R., D.M.S.)
Richez, Ulysse
Autor Richez, Ulysse Carmat SAS, Velizy-Villacoublay, France (B.P., U.R., M.G., A.C., P.J.) Université de Paris, Innovative Therapies in Hemostasis, INSERM, F-75006 Paris, France, Hematology department and Biosurgical Research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, France (C.P., A.P., N.R., U.R., N.G., J.B., J.R., D.M.S.)
Bekbossynova, Mahabbat
Autor Bekbossynova, Mahabbat ORCID National Research Cardiac, Surgery Center, Nur-Sultan, Kazakhstan (Y.P., M.B.)
Gendron, Nicolas
Autor Gendron, Nicolas ORCID Université de Paris, Innovative Therapies in Hemostasis, INSERM, F-75006 Paris, France, Hematology department and Biosurgical Research lab (Carpentier Foundation), AP-HP, Georges Pompidou European Hospital, France (C.P., A.P., N.R., U.R., N.G., J.B., J.R., D.M.S.)
Grimmé, Marc
Autor Grimmé, Marc ORCID Carmat SAS, Velizy-Villacoublay, France (B.P., U.R., M.G., A.C., P.J.)

Arteriosclerosis, thrombosis and vascular biology. 2022 ; 42 (4) : 470-480. [pub] 20220210

Arterioscler Thromb Vasc Biol
ISSN 1524-4636
Medvik
Zdroj

BACKGROUND: Carmat bioprosthetic total artificial heart (Aeson; A-TAH) is a pulsatile and autoregulated device. The aim of this study is to evaluate level of hemolysis potential acquired von Willebrand syndrome after A-TAH implantation. METHODS: We examined the presence of hemolysis and acquired von Willebrand syndrome in adult patients receiving A-TAH support (n=10) during their whole clinical follow-up in comparison with control subjects and adult patients receiving Heartmate II or Heartmate III support. We also performed a fluid structure interaction model coupled with computational fluid dynamics simulation to evaluate the A-TAH resulting shear stress and its distribution in the blood volume. RESULTS: The cumulative duration of A-TAH support was 2087 days. A-TAH implantation did not affect plasma free hemoglobin over time, and there was no association between plasma free hemoglobin and cardiac output or beat rate. For VWF (von Willebrand factor) evaluation, A-TAH implantation did not modify multimers profile of VWF in contrast to Heartmate II and Heartmate III. Furthermore, fluid structure interaction coupled with computational fluid dynamics showed a gradually increase of blood damage according to increase of cardiac output (P<0.01), however, the blood volume fraction that endured significant shear stresses was always inferior to 0.03% of the volume for both ventricles in all regimens tested. An inverse association between cardiac output, beat rate, and high-molecular weight multimers ratio was found. CONCLUSIONS: We demonstrated that A-TAH does not cause hemolysis or AWVS. However, relationship between HMWM and cardiac output depending flow confirms relevance of VWF as a biological sensor of blood flow, even in normal range.

Článek online

Elevated Circulating Stem Cells Level is Observed One Month After Implantation of Carmat Bioprosthetic Total Artificial Heart

Stem cell reviews and reports. 2021 ; 17 (6) : 2332-2337. [pub] 20211007

Stem Cell Rev Rep
ISSN 2629-3277
Medvik
Zdroj

The Aeson® total artificial heart (A-TAH) has been developed as a total heart replacement for patients at risk of death from biventricular failure. We previously described endothelialization of the hybrid membrane inside A-TAH probably at the origin of acquired hemocompatibility. We aimed to quantify vasculogenic stem cells in peripheral blood of patients with long-term A-TAH implantation. Four male adult patients were included in this study. Peripheral blood mononuclear cells were collected before A-TAH implantation (T0) and after implantation at one month (T1), between two and five months (T2), and then between six and twelve months (T3). Supervised analysis of flow cytometry data confirmed the presence of the previously identified Lin-CD133+CD45- and Lin-CD34+ with different CD45 level intensities. Lin-CD133+CD45-, Lin-CD34+CD45- and Lin-CD34+CD45+ were not modulated after A-TAH implantation. However, we demonstrated a significant mobilization of Lin-CD34+CD45dim (p = 0.01) one month after A-TAH implantation regardless of the expression of CD133 or c-Kit. We then visualized data for the resulting clusters on a uniform manifold approximation and projection (UMAP) plot showing all single cells of the live Lin- and CD34+ events selected from down sampled files concatenated at T0 and T1. The three clusters upregulated at T1 are CD45dim clusters, confirming our results. In conclusion, using a flow cytometry approach, we demonstrated in A-TAH-transplanted patients a significant mobilization of Lin-CD34+CD45dim in peripheral blood one month after A-TAH implantation. Using a flow cytometry approach, we demonstrated in A-TAH transplanted patients a significant mobilization of Lin-CD34+CD45dim in peripheral blood one month after A-TAH implantation. This cell population could be at the origin of newly formed endothelial cells on top of hybrid membrane in Carmat bioprosthetic total artificial heart.

Článek

Autoregulation of Pulsatile Bioprosthetic Total Artificial Heart is Involved in Endothelial Homeostasis Preservation

Thrombosis and haemostasis. 2020 ; 120 (9) : 1313-1322. [pub] 20200720

Thromb Haemost
ISSN 2567-689X
Medvik
Zdroj

Pulsatile Carmat bioprosthetic total artificial heart (C-TAH) is designed to be implanted in patients with biventricular end-stage heart failure. Since flow variation might contribute to endothelial dysfunction, we explored circulating endothelial biomarkers after C-TAH implantation in seven patients and compared the manual and autoregulated mode. Markers of endothelial dysfunction and regeneration were compared before and during a 6- to 9-month follow-up after implantation. The follow-up was divided into three periods (< 3, 3-6, and > 6 months) and used to estimate the temporal trends during the study period. A linear mixed model was used to analyze repeated measures and association between tested parameters according to the mode of C-TAH and the time. Relevance of soluble endoglin (sEndoglin) level increase has been tested on differentiation and migration potential of human vasculogenic progenitor cells (endothelial colony forming cells [ECFCs]). Normal sEndoglin and soluble endothelial protein C receptor (sEPCR) levels were found in patients after implantation with autoregulated C-TAH, whereas they significantly increased in the manual mode, as compared with pretransplant values (p = 0.005 and 0.001, respectively). In the autoregulated mode, a significant increase in the mobilization of cytokine stromal cell-derived factor 1 was found (p = 0.03). After adjustment on the mode of C-TAH, creatinine or C-reactive protein level, sEndoglin, and sEPCR, were found significantly associated with plasma total protein levels. Moreover, a significant decrease in pseudotubes formation and migration ability was observed in vitro in ECFCs receiving sEndoglin activation. Our combined analysis of endothelial biomarkers confirms the favorable impact of blood flow variation achieved with autoregulation in patients implanted with the bioprosthetic total artificial heart.