Polymer and Materials Science
Wiley InterScience Backfile Collection 1832-2000
As of this date, tri-segmented intra-aortic balloons made from Avcothane-51 elastomer were applied in the counterpulsation treatment of about 80 cardiac patients. The combined effects induced by the implanted elastomer and the hemodynamics of pumping are analyzed by means of hematologic changes observed in a set of 28 patients who were treated at the Massachusetts General Hospital for an average period of about 4 days, and represent a widely diversified group in terms of their clinical conditions. In no case were, any significant adverse hematologic effects induced by this assist device whether the hosts had been anticoagulated or not heparinized at all. While platelet levels were somewhat affected by the assist device, the particular conditions of the patient appear to have an effect of at least, equal magnitude. In addition to platelet levels steadily decreasing with pumping time, changes in platelet levels similar to the pattern of “platelet tide” occurred with about equal frequency. Monitored in terms of erythrocyte counts and plasma hemoglobin levels, no significant degree of hemolysis could be detected. Leukocyte counts in patients having above-normal levels at the beginning of pumping returned to normal while in other cases there were no significant changes. Fibrinogen, one of the plasma proteins most sensitive to foreign surfaces, showed levels increasing from subnormal to normal as a function of pumping time. The overall in vivo performance of Avcothane-51 balloons appers to be consistent with the state of the surfaces of recovered devices, showing only the presence of occasional adherent platelets upon examination by scanning electron microscopy.
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