Abstract
As treatment options in modern medicine continue to expand, physicians globally have
witnessed a veritable explosion in the utility of therapeutic devices. Particularly
within the spheres of cardiology and critical care medicine, a plethora of devices
are now available with an ever-increasing range of clinical indications. Additionally,
the advent of transcatheter-mounted devices has enabled patients unsuitable for more
invasive procedures to benefit from intervention, thereby greatly expanding the cohort
of device-eligible patients. However, despite advances in design and materials, as
well as pharmacological prophylaxis, hemostatic complications continue to plague device
recipients, contributing to morbidity and mortality. Elucidating the complex interplay
between components of the hemostatic system and cardiac devices has been the subject
of much recent research, with greater focus on the coagulation cascade and device-induced
perturbations. However, less is known about impact of mechanical surfaces on platelets
and the resultant clinical complications, both hemorrhagic and thrombotic. This review
will focus on exploring the pathobiology of platelet–surface interactions, contextualized
within the wider hemostatic system, with a focus on the increasingly utilized technologies
of transcatheter aortic-valve implantation, ventricular assist devices, and extracorporeal
membrane oxygenation.
Keywords
platelets - receptor - shear - platelet function - ventricular assist devices
