Committee:

Wilbur Lam M.D., Ph.D. (Georgia Institute of Technology, Emory University)

Julia Babensee, Ph.D. (Georgia Institute of Technology)

Lakshmi Sankar, Ph.D. (Georgia Institute of Technology)

Kevin Maher, M.D. (Emory University, Children's Healthcare of Atlanta)

Shriprasad Deshpande, M.D. (Emory University, Children's Healthcare of Atlanta)

Towards Improved Device Design and Clinical Management: The Thrombogenic Effect of the Fluid Dynamics and Material Surface Relationship

Blood-contacting medical devices, such as stents, grafts, catheters, extracorporeal circuits, and ventricular assist devices (VADs), are used to treat a variety of cardiovascular and cardiopulmonary diseases. Thrombotic complications are frequent sources of failure for these devices, and the balance of thrombosis, anticoagulation, and hemorrhage is currently an immense clinical challenge. Thrombosis not only hinders device function, but also poses direct risk to the patient. Device thrombosis is currently unpredictable due to a gap in understanding of the interaction of the contributing mechanisms: material surface activation and fluid dynamics. The purpose of this thesis was thus to elucidate the understanding of the material-flow relationship and its effects on bulk thrombotic outcomes, and to use a combination of analysis of clinical data and in vitro modeling to tackle thrombogenic issues in current devices and to make recommendations for future design.