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Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Febbraio;41(1):37-43

lingua: Inglese

A mathematical analysis of hemorheological changes during heart valve replacement

Chen Y., Belboul A., Berglin E., Roberts D.

From the Department of Thoracic and Cardiovascular Surgery Sahlgrenska University Hospital, Gothenburg University Gothenburg, Sweden


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Background. This ­study was car­ried out to estab­lish a math­e­mat­i­cal mod­el in ­order to ­assess ­blood trau­ma and hemo­rhe­ol­o­gy dur­ing car­di­o­pul­mo­nary ­bypass and ­heart ­valve replace­ment.
Methods. Ten fac­tors ­which rep­re­sent­ed ­blood trau­ma and hemo­rhe­ol­o­gy ­were inves­ti­gat­ed in four­teen ­patients under­go­ing mechan­i­cal ­heart ­valve replace­ment.
Results. The ­results con­firmed ­that red ­blood ­cell dam­age was main­ly depen­dent on car­di­o­pul­mo­nary ­bypass ­time and hem­a­toc­rit lev­el. Platelet aggre­ga­tion was influ­enced by plate­let ­count, plas­ma fibrino­gen and car­di­o­pul­mo­nary ­bypass ­time, the cas­es ­with aor­tic ­valve replace­ment result­ing in ­more plate­let acti­va­tion ­than the ­mitral ­valve replace­ment (p<0.05). High ­shear ­blood vis­cos­ity was sig­nif­i­cant­ly influ­enced by hem­a­toc­rit, plas­ma vis­cos­ity and red ­cell fil­ter­abil­ity, ­while low ­shear ­blood vis­cos­ity was sig­nif­i­cant­ly relat­ed to hem­a­toc­rit, plas­ma vis­cos­ity and fibrino­gen con­cen­tra­tion, ­which rep­re­sent­ed 68.5% and 74.8% of hemo­rhe­o­log­ic chang­es due to ­blood trau­ma respec­tive­ly.
Conclusions. The rela­tion­ship ­between ­blood trau­ma and hemo­rhe­o­log­ic chang­es was eval­u­at­ed and the poten­tial are­as for improve­ments in car­di­o­pul­mo­nary ­bypass tech­niques in rela­tion to mechan­i­cal ­heart ­valve implan­ta­tion ­were iden­ti­fied. These are­as of tech­ni­cal and phar­mac­o­log­i­cal devel­op­ment ­must ­reduce chang­es in all the pos­sible plas­ma com­po­nents espe­cial­ly fibrino­gen and ­also pre­serve plate­lets and red ­cells ­from dam­age.

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