{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:55:42Z","timestamp":1789541742844,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T00:00:00Z","timestamp":1751414400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular therapeutic devices typically require systemic heparin due to underlying thrombotic risk. The Impella axial flow system further relies on internal perfusion with either a heparin\u2010containing or sodium bicarbonate purge solution during operation. The combination of systemic and device\u2010mediated heparin often contributes to varying levels of overall anticoagulation, raising the possibility of increased bleeding risk and complications due to heparin sensitivity. To reduce adverse events, efforts have been ongoing to eliminate heparin, both systemically and via the device. Here, we investigate bivalirudin as an alternative to systemic heparin and sodium bicarbonate as an alternative to local device heparin in the purge solution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined hemocompatibility in a mock loop environment with circulating whole porcine blood to determine feasibility of heparin\u2010free Impella system. Anticoagulated (heparin or bivalirudin) blood was loaded into a circulatory loop with a contained Impella 5.5 and run for 4\u2009h with either heparin or sodium bicarbonate\u2010containing purge solution. Blood samples were collected serially and analyzed for metrics of hemocompatibility: hemolysis, platelet activation, and vWF degradation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Bivalirudin and sodium bicarbonate adjunctive environment led to similar or improved hemocompatibility as compared to heparin\u2010containing environment\u2014notably, decreased hemolysis (40\u2009\u00b1\u200920.8\u2009mg\/dL average decrease) and preserved platelet activity measured by P\u2010selectin exposure (8.0\u2009\u00b1\u20095.6% average increase).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data supports the potential to create an overall heparin\u2010free approach simplifying anticoagulation management, offering potential for overall reduced bleeding risk and heparin\u2010related complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31663","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T08:15:13Z","timestamp":1751444113000},"page":"1713-1722","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Enhanced Hemocompatibility via Bivalirudin and Bicarbonate as Alternative to Heparin in a Catheter\u2010Based Axial\u2010Flow System"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8245-3796","authenticated-orcid":false,"given":"Kaitlyn R.","family":"Ammann","sequence":"first","affiliation":[{"name":"Arizona Center for Accelerated Biomedical Innovation Sarver Heart Center University of Arizona Health Sciences, The University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine E.","family":"Outridge","sequence":"additional","affiliation":[{"name":"Arizona Center for Accelerated Biomedical Innovation Sarver Heart Center University of Arizona Health Sciences, The University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiana","family":"Silver","sequence":"additional","affiliation":[{"name":"Arizona Center for Accelerated Biomedical Innovation Sarver Heart Center University of Arizona Health Sciences, The University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Muslmani","sequence":"additional","affiliation":[{"name":"Arizona Center for Accelerated Biomedical Innovation Sarver Heart Center University of Arizona Health Sciences, The University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ding","sequence":"additional","affiliation":[{"name":"Abiomed Inc. Danvers Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Gilman","sequence":"additional","affiliation":[{"name":"Abiomed Inc. Danvers Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Corbett","sequence":"additional","affiliation":[{"name":"Abiomed Inc. Danvers Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin J.","family":"Slepian","sequence":"additional","affiliation":[{"name":"Department of Medicine, Department of Biomedical Engineering Arizona Center for Accelerated Biomedical Innovation, Sarver Heart Center The University of Arizona Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccas.2020.02.004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.03.052"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.oa.23-00076"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2020.00123"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2012.03.002"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2011.08.013"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccl.2018.06.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2024.07.024"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.61"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1546296"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2020.09.003"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/15569845211013329"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14497"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1060028013503623"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/3791307"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/FJC.0000000000001525"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2629"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1160\/TH07-10-0644"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61216-2"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.111.961912"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019064"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.123.063946"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-023-02852-4"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy388"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/10600280221124156"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/08971900221089078"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.820200308"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(89)80299-9"},{"key":"e_1_2_7_30_1","first-page":"297","article-title":"Heparin Effect on Red Blood Cell Aggregation","volume":"31","author":"Kameneva M. 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