The first cause of congenital heart disease is atrial septal defect (ASD). Several devices were developed to close secundum ASD but complications can occur (thromboembolic, infectious…) [1Du Z.D., Hijazi Z.M., Kleinman C.S., y al. Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multi- center nonrandomized trial J Am Coll Cardiol 2002 ;  39 : 1836-1844 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 2Jalal Z., Hascoet S., Baruteau A.E., y al. Long-term complications after transcatheter atrial septal defect closure: a review of the medical literature Can J Cardiol 2016 ;  32 : 1315.e11-1315.e18

Haga clic aquí para ir a la sección de Referencias, 3Chen F., Zhao X., Zheng X., Chen S., Xu R., Qin Y. Incomplete endothelialization and late dislocation after implantation of an Amplatzer septal occluder device Circulation 2011 ;  124 : e188-e189 [cross-ref]

Haga clic aquí para ir a la sección de Referencias]. Providers claim different coatings supposed to improve device haemocompatibility.

To study, in vitro, the ability of 3 devices to be endothelialized by endothelial cells derived from circulating human endothelial progenitors cells (EPCs), to induce platelet or complement activations or coagulation intrinsic pathway activation.

EPCs from umbilical cord blood were extracted, cultured and characterized (CD31, VE-cadherin and von Willebrand factor). Devices were seeded with 100,000 cells/cm². EPC adhesion, at 3 and 24hours, was investigated (biological activity of N acetyl β-D-hexosaminidase). EPC proliferation was monitored with Alamar blue^® test which allowed a longitudinal follow-up (Days 1, 3, 6, 8, 10 and 12). C3a assay was performed after blood-contacting devices (standard ASTM F1984) [4ASTM F1984. Standard practice for testing for whole complement activation in serum by solid materials. In: Annual Book of ASTM Standards, Vol. 13.01.

Haga clic aquí para ir a la sección de Referencias]. Thereafter, platelet activation (via Pselectin and GPIIBIIA) and blood coagulation on biomaterials (standard ASTM F2888, F2382) [5ASTM F2888 – 13 Standard test method for platelet leukocyte count–measure for hemocompatibility assessment of cardiovascular materials. F2888.htm.%202013. [Accessed August 29, 2017].

Haga clic aquí para ir a la sección de Referencias, 6ASTM F2382 – 04 (2010) Standard test method for assessment of intravascular medical device materials on partial thromboplastin time (PTT). F2382.htm. 2010. [Accessed August 28, 2017].

Haga clic aquí para ir a la sección de Referencias] were explored.

With regard to EPCs adhesion and proliferation (Fig. 1, Fig. 2), no statistically significant differences were found between 3 devices. There was a significant EPC proliferation on each device as a function of time appearing at Day 8 for devices 2 and 3 and Day 10 for device 1. No complement activation was detected by the C3a assay (device 1: 3584±978ng/mL, device 2: 3386±1092ng/mL and device 3: 4612±1657ng/mL) (Fig. 3). No platelet activation occurred within 15min of contact with devices (Figs 4 and 5). However, there was a minimal activation of coagulation for 3 devices (Mean time for PTT test on device 1: 183±23.3 s, device 2: 170.7±22.2 s and device 3: 167±22.6 s).

Despite different coatings, the haemocompatibility of three devices was comparable. The benefit of effective anticoagulation should be confirmed by future clinical studies.