Thrombosis protein-coated surfaces

The presence of low concentrations of proteins such as fibronectin and/ or von Willebrand factor can drastically alter the thrombotic response on a fibrinogen-coated surface, indicating that proteins that have yet to be characterized may contribute greatly to thrombosis. 

Cardiac valves with components fabricated from low temperature isotropic carbons (pyrolytic carbon) are successfully used clinically [23]. These materials are appropriate for such applications as mechanical valves which require long-term chemical inertness, smoothness, and wear-resistance. The reasons for the marked improvement in the performance (reduced thrombosis and thromboembolic stroke rates) of these newer vs. older style heart valves are not entirely understood, but are undoubtedly multifactorial and related to improved patient management and valve design, as well as to the nature of the carbon surface. The specific benefits conferred by pyrolytic carbons with respect to blood cell and protein interactions, resulting in a very low frequency of clinical complications, remain to be defined. The use of carbon coatings has been proposed for other devices, i.e., vascular grafts, although such devices have not yet been used clinically. 

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