Mathematical model for qualitative assessment of blood pump-induced thrombosis and stroke risk

To guide clinical treatment and optimize blood pump design, a mathematical model was developed to evaluate thrombosis and stroke risks induced by blood pumps. Incorporating platelet receptor synthesis/shedding and von Willebrand factor (vWF) unfolding/degradation under shear stress, the model assessed hemorrhagic stroke risk based on shear stress-impaired platelet-vWF binding and thrombosis risk through shear stress-enhanced platelet-vWF interactions leading to hypercoagulability and blood stagnation. The model was validated using three blood pumps—HeartWare, HeartMate II, and HeartMate 3—showing consistency with clinical evidence. Thrombosis risk ranked as HeartMate II > HeartWare > HeartMate 3, primarily due to blood stagnation and shear stress-induced hypercoagulability. Hemorrhagic and ischemic stroke risks followed the ranking HeartWare > HeartMate II > HeartMate 3, with ischemic stroke regions overlapping shear stress and thrombosis-prone regions. Reducing narrow clearances and stagnation regions and avoiding regions of overlapping high shear stress and prolonged residence time can enhance hemocompatibility. The model accurately identified high-risk regions for thrombosis and stroke, providing insights for optimizing blood pump design and clinical strategies.