Understanding Platelet Activation in the Aeson Bioprosthetic Total Artificial Heart: Insights From Aspirin Treatment and Outcomes

Smadja D.M. De Bezieux J.R. Peronino C. Jilet L. Ivak P. Pya Y. Philippe A. Latremouille C. Gustafsson F. Ramjankhan F.Z. Roussel J.C. Courbebaisse M. Parfait B. Lebeaux D. Friedlander G. Vincentelli A. Flecher E. Gaussem P. Jansen P. Netuka I.
1 September 2025 Lippincott Williams and Wilkins

ASAIO Journal
2025 #71 Issue 9 701 - 710 pp.

This study aimed to assess platelet activation following implantation of the Aeson bioprosthetic total artificial heart (A-TAH). We monitored plasma levels of platelet activation markers in patients receiving A-TAH support (n = 16) throughout the follow-up period. Before implantation, soluble CD40 ligand (sCD40L) levels averaged 3,909.06 pg/ml (standard deviation [SD] = 3,772.37), remaining stable postimplantation at 3,964.56 pg/ml (SD = 2,198.85) during months 1-3 and at 3,519.27 pg/ml (SD = 1,647.04) during months 3-6. Similarly, P-selectin (sP-sel) levels were 35,235.36 pg/ml (SD = 14,940.47) before implantation, stabilizing to 33,158.96 pg/ml (SD = 9,023.11) (1-3 months) and 31,022.58 pg/ml (SD = 9,249.95) (3-6 months). Preimplantation platelet factor 4 (PF4) measured 2,593.47 ng/ml (SD = 2,167.85), remaining consistent at 2,136.10 ng/ml (SD = 1,264.47) (1-3 months) and 1,991.26 ng/ml (SD = 1,234.16) (3-6 months). Levels of neutrophil-activating peptide 2 (NAP2) were also steady, measuring 785.63 ng/ml (SD = 605.26) preimplantation, 935.10 ng/ml (SD = 517.73) at 1-3 months, and 907.21 ng/ml (SD = 501.96) at 3-6 months postimplantation. Importantly, neither aspirin nor heparin treatment affected these platelet biomarker levels. No correlation was observed between platelet activation marker levels and clinical outcomes such as pericardial effusion, nor with the timing of aspirin initiation and drain removal. Our findings confirm that A-TAH does not trigger platelet activation. The lack of association between aspirin, platelet activation, and clinical outcomes suggests the possibility of discontinuing antiplatelet therapy following A-TAH implantation in the future.

artificial , aspirin , biomarkers , heart , platelet activation , platelet aggregation inhibitors

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Université Paris Cité, Inserm U970, Paris Cardiovascular Research Center, Team Endotheliopathy and Hemostasis Disorders, Paris, France
Hematology Department, AP-HP, Georges Pompidou European Hospital, Paris, France
Carmat Sa, Velizy-Villacoublay, France
Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
Department of Physiology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
National Research Cardiac Surgery Center, Nur-Sultan, Kazakhstan
Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark
University Medical Center Utrecht, Utrecht, Netherlands
Cardiac and Thoracic Surgery Department, Chu de Nantes, Hôpital Nord Laënnec, boulevard Jacques-Monod, Nantes Cedex 1, Saint-Herblain, France
Physiology Department, AP-HP, Georges Pompidou European Hospital, Paris, France
Genetic Department, AP-HP, Cochin Hospital, Paris, France
Infectious Diseases Department, AP-HP, Saint Louis Hospital, Paris, France
Paris Cité University Foundation, Paris, France
Department of Cardiac Surgery, Chu Lille, Inserm, Institut Pasteur de Lille, Lille University, Lille, France
Division of Cardiothoracic and Vascular Surgery, Pontchaillou University Hospital, Rennes, France

Université Paris Cité
Hematology Department
Carmat Sa
Department of Cardiovascular Surgery
Department of Physiology
National Research Cardiac Surgery Center
Department of Cardiology
University Medical Center Utrecht
Cardiac and Thoracic Surgery Department
Physiology Department
Genetic Department
Infectious Diseases Department
Paris Cité University Foundation
Department of Cardiac Surgery
Division of Cardiothoracic and Vascular Surgery

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