"HyperShear in a Channel": A Microfluidic Facsimile of Mechanical Circulatory Support Devices to Reduce Thrombotic Risk and Enhance Patient Safety

Dimasi, Annalisa ;   Consolo, Filippo ;   Valerio, Lorenzo ;   Rasponi, Marco ;   Tran, Phat ;   Redaelli, Alberto ;   Bluestein, Danny ;   Slepian, Marvin J.

Thrombosis of mechanical circulatory support devices ? e.g. ventricular assist devices (VADs) may have life-threatening consequences. Presently anti-thrombotic drugs (aspirin and dipyridamole) are utilized to mitigate thrombotic risk, being dosed empirically, without individualized testing of efficacy in a given patient. To date testing systems available for examining anti-platelet agent efficacy are limited in that they are largely central lab-based and typically examine drug efficacy under conditions that do not represent the flow and shear conditions of the patient during actual VAD use. Here we adopt a technology, Device Thrombogenicity Emulation ? a methodology developed by our group which characterizes the actual shear stress history experienced by platelets in a blood recirculating device, i.e. total exposure level, individual platelet flight trajectories - and utilize this to create a facsimile of the shear stress profile of a VAD in a small footprint microfluidic channel point-of-care system. Creating a device-specific microfluidic facsimile will allow the development of a point-of-care testing system reflective of an actual device in a given patient. This will afford determination of anti-thrombotic agent efficacy under personalized conditions, reducing the likelihood of VAD thrombosis and increasing patient safety.