Left Ventricular Assist Devices: Challenges Toward Sustaining Long-Term Patient Care
Abstract
Over the last few decades, the left ventricular assist device (LVAD) technology has been tremendously improved transitioning from large and noisy paracorporeal volume displacement pumps to small implantable turbodynamic devices with only a single transcutaneous element, the driveline. Nevertheless, there remains a great demand for further improvements to meet the challenge of having a robust and safe device for long-term therapy. Here, we review the state of the art and highlight four key areas of needed improvement targeting long-term, sustainable LVAD function: (1) LVADs available today still have a high risk of thromboembolic and bleeding events that could be addressed by the rational fabrication of novel surface structures and endothelialization approaches aiming at improving the device hemocompatibility. (2) Novel, fluid dynamically optimized pump designs will further reduce blood damage. (3) Infection due to the paracorporeal driveline can be avoided with a transcutaneous energy transmission system that additionally allows for increased freedom of movement. (4) Finally, the lack of pump flow adaptation needs to be encountered with physiological control systems, working collaboratively with biocompatible sensor devices, targeting the adaptation of the LVAD flow to the perfusion requirements of the patient. The interdisciplinary Zurich Heart project investigates these technology gaps paving the way toward LVADs for long-term, sustainable therapy. Show more
Permanent link
https://doi.org/10.3929/ethz-b-000229689Publication status
publishedExternal links
Journal / series
Annals of Biomedical EngineeringVolume
Pages / Article No.
Publisher
SpringerSubject
Adverse events; Heart failure; Cardiac surgery; Surface structure; Hemocompatibility; Fluid dynamics; Implantability; Physiological controlOrganisational unit
03943 - Meboldt, Mirko / Meboldt, Mirko
03462 - Poulikakos, Dimos (emeritus) / Poulikakos, Dimos (emeritus)
03605 - Mazza, Edoardo / Mazza, Edoardo
Notes
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.More
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