Ventricular assist device (VAD) implantation is an effective treatment for patients with end-stage heart failure. However, patients who undergo long-term application of VADs experience a series of VAD-related adverse effects including pump thrombosis, which is induced by rotate impeller-caused blood cell injury and hemolysis. Blood cell trauma-related flow patterns are the key mechanism for understanding thrombus formation. In this study, we established a new method to evaluate the blood cell damage and investigate the real-time characteristics of blood flow patterns in vitro using rheometer and bionic microfluidic devices. The variation of plasma free hemoglobin (PFH) and lactic dehydrogenase (LDH) in the rheometer test showed that high shear stress was the main factor causing erythrocyte membrane injury, while the long-term exposure of high shear stress further aggravated this trauma. Following this rheometer test, the damaged erythrocytes were collected and injected into a bionic microfluidic device. The captured images of bionic microfluidic device tests showed that with the increase of shear stress suffered by the erythrocyte, the migration rate of damaged erythrocyte in bionic microchannel significantly decreased and, meanwhile, aggregation of erythrocyte was clearly observed. Our results indicate that mechanical shear stress caused by erythrocyte injury leads to thrombus formulation and adhesion in arterioles.
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