The Biocompatibility Challenges in the Total Artificial Heart Evolution.

IF 12.8 1区工程技术 Q1 ENGINEERING, BIOMEDICAL

Annual Review of Biomedical Engineering Pub Date : 2019-06-04 Epub Date: 2019-02-22 DOI:10.1146/annurev-bioeng-060418-052432

Eleonora Dal Sasso, Andrea Bagno, Silvia T G Scuri, Gino Gerosa, Laura Iop

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引用次数: 15

Abstract

There are limited therapeutic options for final treatment of end-stage heart failure. Among them, implantation of a total artificial heart (TAH) is an acceptable strategy when suitable donors are not available. TAH development began in the 1930s, followed by a dramatic evolution of the actuation mechanisms operating the mechanical pumps. Nevertheless, the performance of TAHs has not yet been optimized, mainly because of the low biocompatibility of the blood-contacting surfaces. Low hemocompatibility, calcification, and sensitivity to infections seriously affect the success of TAHs. These unsolved issues have led to the withdrawal of many prototypes during preclinical phases of testing. This review offers a comprehensive analysis of the pathophysiological events that may occur in the materials that compose TAHs developed to date. In addition, this review illustrates bioengineering strategies to prevent these events and describes the most significant steps toward the achievement of a fully biocompatible TAH.

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全人工心脏进化中的生物相容性挑战。

终末期心力衰竭的最终治疗选择有限。其中，当没有合适的供体时，植入全人工心脏(TAH)是一种可接受的策略。TAH的发展始于20世纪30年代，随后是机械泵驱动机构的戏剧性演变。然而，TAHs的性能尚未得到优化，主要是因为血液接触表面的生物相容性较低。血液相容性低、钙化和对感染的敏感性严重影响TAHs的成功。这些未解决的问题导致许多原型在临床前测试阶段被撤回。这篇综述提供了一个全面的分析，可能发生的病理生理事件的材料组成的TAHs发展至今。此外，本文还阐述了预防这些事件的生物工程策略，并描述了实现完全生物相容性TAH的最重要步骤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annual Review of Biomedical Engineering 工程技术-工程：生物医学

CiteScore

18.80

自引率

0.00%

发文量

期刊介绍： Since 1999, the Annual Review of Biomedical Engineering has been capturing major advancements in the expansive realm of biomedical engineering. Encompassing biomechanics, biomaterials, computational genomics and proteomics, tissue engineering, biomonitoring, healthcare engineering, drug delivery, bioelectrical engineering, biochemical engineering, and biomedical imaging, the journal remains a vital resource. The current volume has transitioned from gated to open access through Annual Reviews' Subscribe to Open program, with all articles published under a CC BY license.