Work

Polyurethane versus pericardium: Contrasting hemocompatibility in 2 different total artificial hearts

Year: 2026

Type: article

Abstract: Mechanical circulatory support is widely used in heart failure to support or replace the failing heart.However, hemocompatibility remains a concern because of the risks of thrombosis and bleeding.Acquired von Willebrand syndrome (AVWS), linked to left ventricular assist devices, is a key contributor to bleeding, caused by shear stress-induced degradation of high molecular weight multimers (HMWMs) of von Willebrand factor (vWF), the most active form of the protein. 1 Total artificial hearts (TAHs) replace both ventricles and generate pulsatile flow.The STAH (SynCardia) uses polyurethane (PU) for its blood-contacting surfaces.The Aeson TAH (A-TAH; CARMAT SAS), Conformit� e Euro-p� eenne-marked in 2020, features bovine pericardium valves and membranes, with expanded polytetrafluoroethylene elsewhere.Our team previously reported no AVWS in patients with A-TAH, unlike those with HeartMate II (HM-II) or HeartMate 3 (HM-3) (both from Abbott Cardiovascular). 2 Furthermore, the pericardium provides an acquired hemocompatibility, with preliminary results showing signs of membrane recellularization.3 In comparison, contradictory data exist on AVWS for patients with STAH, 4,5 and no analysis was performed of the PU after explantation of the TAH.This study aims to assess HMWM degradation and bloodmaterials interaction in the STAH compared with A-TAH.

Source: JTCVS Open

DOI: 10.1016/j.xjon.2026.101937