fibrin and Shock--Cardiogenic

Explant analysis of left ventricular assist systems (LVAS) should permit a better evaluation of long-term evolution of materials and tissue healing in patients supported by mechanical devices and a precise understanding of embolic phenomena, observed clinically.. Five Novacor LVAS and their conduits have been explanted after 156 days (range 61-226 days) of mechanical support. The pseudo-intima (PI) developed in the inflow and outflow conduits was characterized microscopically, using monoclonal antibodies.. The morphological aspects of PI were quite different in the inflow and outflow conduits. Blood coagulation between the basal surface of the PI and the Dacron tube, irregular collagen type I matrix with plasma infiltration, macrophages, and neutrophil granulocyte elastase characterized the nonadherent, loose, and potentially thrombogenic PI growth in the inflow conduit. The PI from collagen types I and IV with circumferentially oriented alpha-smooth muscle cell actin-positive cells was anchored to the outflow conduits.. The observations, which have to be confirmed by a more extensive study on a larger number of specimens, suggest the role of the biomaterial itself, as well as the configuration, physical characteristics, and rheology in the conduit. They also suggest that thromboembolic complications of LVAS may eventually be related to this host tissue response.

Topics: Adolescent; Adult; Blood Coagulation; Blood Vessel Prosthesis; Cell Count; Collagen; Embolism; Female; Fibrin; Heart-Assist Devices; Humans; Immunoenzyme Techniques; Male; Materials Testing; Middle Aged; Polyethylene Terephthalates; Prosthesis Design; Rheology; Shock, Cardiogenic; Tunica Intima; Wound Healing

Causal connection between shock and SACH has been suggested on the basis of clinical analysis. In a case of cardiogenic shock demonstrating criteria of initial SACH, successful identification of intravascular fibrinoid thrombi is presented as valid evidence for this pathogenetic presumption.

Topics: Aged; Cholecystitis; Fibrin; Gallbladder Diseases; Humans; Rectal Neoplasms; Shock, Cardiogenic; Thrombosis

Topics: Acute Kidney Injury; Aged; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Female; Fibrin; Fibrinogen; Heparin; Humans; Kidney; Male; Middle Aged; Myocardial Infarction; Shock, Cardiogenic

Topics: Animals; Assisted Circulation; Blood Cells; Blood Platelets; Cattle; Cell Adhesion; Dextrans; Erythrocytes; Fibrin; Heparin; Humans; Leukocytes; Microscopy, Electron, Scanning; Myocardial Infarction; Shock, Cardiogenic; Surface Properties; Thrombosis; Time Factors

Topics: Arrhythmias, Cardiac; Burns; Diabetic Coma; Fibrin; Fibrinogen; Heart Failure; Humans; Intensive Care Units; Lung Diseases, Obstructive; Myocardial Infarction; Poisoning; Shock, Cardiogenic; Tetanus

Topics: Acute Disease; Adult; Aged; Blood Coagulation Tests; Diagnosis, Differential; Female; Fibrin; Humans; Male; Middle Aged; Myocardial Infarction; Sex Factors; Shock, Cardiogenic; Time Factors

Topics: Adult; Blood Coagulation Disorders; Electrocardiography; Embolism, Amniotic Fluid; Female; Fibrin; Humans; Phenethylamines; Prednisolone; Pregnancy; Pulmonary Heart Disease; Radiography; Shock, Cardiogenic