Cardiovascular Engineering and Technology最新文献

{"title":"A Novel Catheter-Based Method for Denervation of Afferent Renal Nerves in Sheep.","authors":"Arthur de la Cruz-Lynch, Brianna Dailey-Krempel, Alex Dayton, Duc T Nguyen, Roman Tyshynsky, Dusty Van Helden, Matthew Lahti, John Carney, Louise Evans, Lucy Vulchanova, John Osborn","doi":"10.1007/s13239-025-00786-x","DOIUrl":"10.1007/s13239-025-00786-x","url":null,"abstract":"<p><strong>Purpose: </strong>Catheter-based total renal denervation (TRDN) has recently gained FDA approval to lower blood pressure in patients with treatment-resistant hypertension. Current TRDN technologies indiscriminately destroy efferent (sympathetic) and afferent (sensory) renal nerves. However, preclinical studies suggest that the beneficial effects of TRDN may be due to ablation of afferent, rather than efferent, renal nerves. We developed a novel method for chemical ablation of afferent renal nerves by periaxonal application of capsaicin which has been employed in mouse and rat models of hypertension. In certain rodent models afferent-specific renal denervation (ARDN) has been shown to lower arterial pressure to the same degree as TRDN. The objective of the present study was to develop a catheter-based method for ARDN in a large animal model with the long-term goal of translating this treatment to humans. We tested the feasibility of using the Peregrine™ catheter infusion system, currently used to perform TRDN in humans by injection of ethanol, to perform catheter-based afferent renal denervation in sheep by periaxonal application of capsaicin.</p><p><strong>Methods: </strong>Castrated, adult, male, Friesen sheep underwent Sham RDN (saline, n = 2), TRDN (ethanol, n = 4), or ARDN (capsaicin, n = 4) with the Peregrine™ catheter before termination > 2 weeks after the procedure. Denervation of renal efferents was verified by measurement of renal cortical norepinephrine (NE) content and anti-tyrosine hydroxylase (TH) staining; denervation of renal afferents was verified with anti-calcitonin gene-related peptide (CGRP) staining.</p><p><strong>Results: </strong>There was a significant decrease in TH + and CGRP + fibers in TRDN kidneys and in CGRP + but not TH + fibers in ARDN kidneys. TRDN significantly reduced renal cortical norepinephrine (NE) content by 89% while ARDN had similar NE content to Sham RDN kidneys.</p><p><strong>Conclusions: </strong>This study establishes the feasibility of performing catheter-based afferent renal denervation in a large animal model. Furthermore, this study provides a translational model to evaluate catheter-based ARDN as a potential treatment for hypertension.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"455-464"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the Radiopacity of an Injectable Polymer on Fluoroscopy used for Treatment of Type II Endoleak After Endovascular Aneurysm Repair.","authors":"Jeffrey R Nagel, Erik Groot Jebbink, Stefan P M Smorenburg, Arjan W J Hoksbergen, Rutger J Lely, Michel Versluis, Michel M P J Reijnen","doi":"10.1007/s13239-025-00779-w","DOIUrl":"10.1007/s13239-025-00779-w","url":null,"abstract":"<p><strong>Purpose: </strong>Type II endoleaks (T2EL) are a common complication after endovascular aneurysm repair. AneuFix is a newly designed elastic polymer for T2EL. AneuFix contains tantalum for visualization during fluoroscopy, which is crucial for monitoring the polymer in the side branches. The purpose of this study was to find the lowest concentration tantalum that is sufficient for safe injection in the aneurysmal sac.</p><p><strong>Methods: </strong>AneuFix polymer with tantalum concentrations between 0 and 30% was injected into endoleak phantoms, connected to a pulsatile flow setup and with a realistic background for fluoroscopy. Furthermore, the radiopacity was investigated on fluoroscopic systems from three different vendors, using static phantoms. Results from both the dynamic and static phantoms were qualitatively evaluated by 10 clinical experts.</p><p><strong>Results: </strong>Concentrations of ≥ 20% tantalum were consistently detected within the first 5 mm after entering the side branch, with a corresponding contrast-to-noise ratio of 2.23 ± 0.21. Furthermore, sufficient detectability scores (of at least 3 out of 5) were given to ≥ 15% tantalum. Significant differences were found in detectability scores on different fluoroscopic systems, using the default lowest-radiation-dose scan protocol for each system.</p><p><strong>Conclusions: </strong>This study showed that tantalum concentrations ≥ 20% are consistently detected on fluoroscopy in the specified region. Compared to the original 30%, this would reduce imaging artifacts from high attenuation and scattering on follow-up imaging, while retaining sufficient detectability during injection. However, because of differences in fluoroscopic systems and scan protocols between hospitals, the combination of tantalum concentration and scan protocol should be optimized for each clinical setting.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"377-385"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Transcatheter Edge-to-Edge Repair on Left Ventricular Flow Features.","authors":"Xinyi He, Shuyi Feng, Fan Wu, Hongping Wang, Shizhao Wang, Xiangbin Pan","doi":"10.1007/s13239-025-00781-2","DOIUrl":"10.1007/s13239-025-00781-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the effects of transcatheter edge-to-edge repair (TEER) on left ventricular hemodynamics and its potential implications for patient health.</p><p><strong>Methods: </strong>An in vitro experimental platform was designed to replicate the anatomical and functional characteristics of the left ventricle (LV). This platform integrates native porcine mitral and aortic valves with a patient-specific 3D-printed silicone LV. The LV hemodynamics after TEER is assessed using echocardiography and particle image velocimetry, focusing on critical indices such as vorticity, Reynolds shear stress (RSS), viscous shear stress (VSS), and energy dissipation rate (ε).</p><p><strong>Results: </strong>TEER effectively reduces the degree of mitral regurgitation (MR); however, it significantly increases RSS, VSS, and ε due to the formation of numerous small-scale vortices in the LV.</p><p><strong>Conclusion: </strong>These hemodynamic changes may lead to adverse left ventricular remodeling, red blood cell damage, and reduced cardiac pumping efficiency, which have to be taken into consideration to optimize the TEER procedure and improve patient outcomes.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"386-399"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Mechanical Circulatory Support Devices on White Blood Cell Phenotype and Function.","authors":"Zhuo Li, Zhenling Wei, Wangwang Su, Longhui Cheng, Liudi Zhang","doi":"10.1007/s13239-025-00784-z","DOIUrl":"10.1007/s13239-025-00784-z","url":null,"abstract":"<p><strong>Background: </strong>Mechanical circulatory support devices (MCSDs) have gradually become an effective treatment of end-stage heart failure (HF). However, the introduction of foreign surfaces and non-physiological shear stress (NPSS) can cause severe damage to various blood cells, leading to impaired function of immune system and increased risk of complications such as inflammation and thrombosis. The effect of mechanical injury on white blood cell (WBC) has been largely neglected compared to that on red blood cell (RBC) and platelet (PLT).</p><p><strong>Method: </strong>To better understand the impact of MCSDs on WBCs and emphasize the importance of investigating WBC damage to avoid adverse events during mechanical circulatory support, this review elaborated the induction of WBC phenotypic and functional injury by MCSD-related factors, and the relationship between injury and clinical complications. Furthermore, this article provided a detailed review and comparative analysis of in vitro blood-shearing devices (BSDs) and detection methods used in WBC damage investigation.</p><p><strong>Results: </strong>NPSS, biomaterials and other related factors can activate WBC, decrease WBC function, and promote the release of pro-inflammatory and pro-thrombotic microparticles, increasing the risk of inflammation and thrombotic complications. The evaluation of WBC damage typically involves measuring cell viability and dysfunction using in vitro BSDs (e.g. concentric cylinder devices) and injury detection methods (e.g. flow cytometry).</p><p><strong>Conclusions: </strong>WBCs with normal morphology may also experience functional failure due to NPSS from MCSDs, leading to sublethal mechanical cell injury. Therefore, the effect of MCSDs on WBCs can be more comprehensively evaluated by a combination of measuring cell functional capacity and cell counting.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"423-434"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrioventricular Synchrony Algorithm Modeling of a Leadless Pacemaker Family: A Virtual Patient Analysis.","authors":"Miguel A Leal, Todd Sheldon, Keelia Escalante, Mikayle Holm, Michelle Galarneau, Kurt Stromberg, Jonathan P Piccini","doi":"10.1007/s13239-025-00783-0","DOIUrl":"10.1007/s13239-025-00783-0","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of enhancements to the Atrioventricular Synchrony (AVS) algorithms of a next generation Micra leadless pacemaker (Micra AV2).</p><p><strong>Methods: </strong>Accelerometer data were extracted from the AccelAV clinical study and were used to create virtual patients. A series of Monte Carlo simulations were run for each virtual patient to compare an enhanced Atrial Sensing Setup algorithm and Auto + A3 Threshold algorithm vs. original algorithms. A real-world survey was also conducted to observe clinical time savings from AVS programming burden reduction.</p><p><strong>Results: </strong>The enhanced Atrial Sensing Setup in Micra AV2 devices demonstrated > 70% AVS in 27 of 30 (90%) patients while 13 of 30 (43%) Micra AV patients had > 70% AVS (p < 0.001) with no manual programming. The Micra AV2 Auto + A3 Threshold without additional manual programming demonstrated improved overall ambulatory AVS in the 80-100 bpm range (84.1%). Based upon survey results, the enhanced Atrial Sensing Setup algorithm accounted for an estimated reduction in median device check time of 13 min per patient.</p><p><strong>Conclusions: </strong>Simulation-based analyses of the Micra AV2 leadless pacemaker projected significant improvements in automatic AVS at high sinus rates and an increase in the number of patients with > 70% AVS without clinician programming. Real-world survey results reported a reduction in device check time with the improvements.</p><p><strong>Significance: </strong>Improvements in the AVS algorithms in Micra AV2 allow for better automatic AVS at higher heart rates and reduced clinic utilization burden.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"410-422"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amplification of Secondary Flow at the Initiation Site of Intracranial Sidewall Aneurysms.","authors":"Benjamin Csippa, Péter Friedrich, István Szikora, György Paál","doi":"10.1007/s13239-025-00771-4","DOIUrl":"10.1007/s13239-025-00771-4","url":null,"abstract":"<p><strong>Purpose: </strong>The initiation of intracranial aneurysms has long been studied, mainly by the evaluation of the wall shear stress field. However, the debate about the emergence of hemodynamic stimuli still persists. This paper builds on our previous hypothesis that secondary flows play an important role in the formation cascade by examining the relationship between flow physics and vessel geometry.</p><p><strong>Methods: </strong>A composite evaluation framework was developed to analyze the simulated flow field in perpendicular cross-sections along the arterial centerline. The velocity field was decomposed into secondary flow components around the centerline in these cross-sections, allowing the direct comparison of the flow features with the geometrical parameters of the centerline. Qualitative and statistical analysis was performed to identify links between morphology, flow, and the formation site of the aneurysms.</p><p><strong>Results: </strong>The normalized mean curvature and curvature peak were significantly higher in the aneurysmal bends than in other arterial bends. Similarly, a significant difference was found for the normalized mean velocity ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.0274</mn></mrow> </math> ), the circumferential ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.0029</mn></mrow> </math> ), and radial ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.0057</mn></mrow> </math> ) velocity components between the arterial bends harboring the aneurysm than in other arterial bends. In contrast, the difference of means for the normalized axial velocity is insignificant ( <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.1471</mn></mrow> </math> ).</p><p><strong>Conclusion: </strong>Thirty cases with aneurysms located on the ICA were analyzed in the virtually reconstructed pre-aneurysmal state by an in-silico study. We found that sidewall aneurysm formation on the ICA is more probable in these arterial bends with the highest case-specific curvature, which are accompanied by the highest case-specific secondary flows (circumferential and radial velocity components) than in other bends.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"259-271"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arteriolar Elasticity Measurement in the Fingertip Based on Photoplethysmographic Volume-Oscillometry: A New Approach to the Assessment of Vasomotor Functions in the Microvasculature.","authors":"Ken-Ichi Yamakoshi, Peter Rolfe, Takehiro Yamakoshi","doi":"10.1007/s13239-025-00772-3","DOIUrl":"10.1007/s13239-025-00772-3","url":null,"abstract":"<p><strong>Purpose: </strong>Dysfunction of vasomotor reactions due to arteriolar smooth muscle causes serious adverse events, such as loss of hemodynamic coherence. This in turn can increase risks of cardiovascular-related diseases. A noninvasive and quantitative evaluation of microvascular disorder is therefore very important for early diagnosis and treatment. This paper describes a new approach to the assessment of vasomotor functions using the arteriolar elasticity measurement technique in the fingertip.</p><p><strong>Methods: </strong>A recently developed device, modified to detect a photoplethysmogram with green light (gPPG) in arteriolar regions, allowed the measurement of arteriolar blood pressure (BP_ca.) and gPPG from a left index fingertip placed on an occlusive cuff of the device. Arteriolar stiffness and distensibility were analyzed as effective elasticity indices, as a function of arteriolar distending pressure derived by volume-oscillometry. Cold pressor tests to induce vasoconstriction were carried out whether appropriate elasticity changes could be obtained.</p><p><strong>Results: </strong>Experiments using 6 healthy subjects were successfully made to obtain arteriolar elastic properties before and while immersing a right hand in cold water. The index-values of stiffness and distensibility showed, respectively, a considerable increase and decrease, clearly demonstrating the appropriate elasticity changes with vasoconstrictive reactions.</p><p><strong>Conclusion: </strong>Although a further study using many subjects is needed, the results so far suggest that this method could easily provide important features to acquire quantitatively arteriolar elasticity together with BP_ca. and to assess vasomotor functions in the microvasculature. This convenient method appears useful for clinical practices and health management and promising also for screening cardiovascular-related diseases. (242/250 words).</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"272-278"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Inter-Patient, Intra-Patient, and Patient-Specific Based Training in Deep Learning for Classification of Heartbeat Arrhythmia.","authors":"Reza Bahrami, Ali Mohammad Fotouhi","doi":"10.1007/s13239-025-00777-y","DOIUrl":"10.1007/s13239-025-00777-y","url":null,"abstract":"<p><p>Effective diagnosis of electrocardiogram (ECG) is one of the simplest and fastest ways to assess the heart's function. In the recent decade, various attempts have been made to automate the classification of electrocardiogram signals to detect heartbeat arrhythmias based on deep learning. However, due to the lack of a comprehensive standard for how to divide the database into the train and test datasets and the variety of methods used for this purpose, it is not possible to make a fair comparison between many of these studies. One of the main criteria for creating train and test datasets that have a great impact on the final results is their distribution paradigm. There are three paradigms for this purpose, including Inter-Patient, Intra-Patient, and Patient-Specific. In this research, we have conducted a detailed study of the impact of these three paradigms on the final results obtained from a CNN-based deep learning model for the classification of heartbeat arrhythmia into five classes. The experimental results on the standard arrhythmia dataset show that the Patient-Specific reached the best average performance in all of the metrics. Also, this training pattern is more practical and can be employed to create patient customized devices for the classification of ECG arrhythmia.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"333-342"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Transcatheter Device to Treat Calcific Aortic Valve Stenosis: An Ex Vivo Study.","authors":"Francesca Perico, Eleonora Salurso, Fabio Pappalardo, Michal Jaworek, Enrico Fermi, Maria Chiara Palmieri, Flavius Constantin Apostu, Riccardo Vismara, Marco Vola","doi":"10.1007/s13239-025-00774-1","DOIUrl":"10.1007/s13239-025-00774-1","url":null,"abstract":"<p><strong>Purpose: </strong>Aortic valve stenosis (AVS) is the most common valvular disease in developed countries. Surgical or transcatheter bioprosthetic aortic valve (AV) replacement is the standard treatment for severe AVS. However, bioprostheses are prone to structural degeneration. Hence, in terms of lifetime management, there is a need for therapies that can postpone AV replacement. With the aim of fragmenting calcifications and restoring AV leaflets flexibility, a new transcatheter debridement device (TDD) exploiting ultrasound is under development. We performed an ex-vivo study on human hearts to quantify how TDD treatment affects stenotic AVs hemodynamic. Additionally, a qualitative histological analysis was performed to assess TDD's impact on AV leaflets.</p><p><strong>Methods: </strong>Three human hearts affected by AVS were characterized pre- and post-treatment in an ex-vivo beating heart simulator. To replicate physiological flowrates, a pulsatile pump was connected to the left ventricle, while a systemic impedance simulator connected to the aortic root and a reservoir connected to the left atrium closed the hydraulic circuit. Transvalvular pressure drop (ΔPsys), backflow volume, and effective orifice area (EOA) were evaluated. For histological analysis, AV leaflets sections were stained with Haematoxylin/Eosin and AlizarineRedS to highlight calcifications.</p><p><strong>Results: </strong>The treatment induced a reduction in ΔPsys in all tested samples, improving EOA, but caused an increase in backflow volume. Moreover, histology suggested AV leaflets integrity.</p><p><strong>Conclusions: </strong>The TDD procedure improved AV fluid-dynamics during systole in all tested samples, without evidence of damage to tissues. This suggests TDD could be a promising option to postpone AV replacement for patients with AVS.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"296-306"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Technological Analysis of Durability and Reliability in Axial-Flow Pump Left Ventricular Assist Devices (LVADs).","authors":"Amin Khorshid Savar, Hongrui Wang, Nuo Chen, Yunzhang Cheng","doi":"10.1007/s13239-025-00778-x","DOIUrl":"10.1007/s13239-025-00778-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study addresses the critical gap in the literature regarding the comparative analysis of axial flow left ventricular assist devices (LVADs). Despite technological advancements, there is a notable lack of integrated studies focusing solely on axial flow pumps and comparing multiple models with the same technology. This gap limits developers' access to comprehensive technical information essential for innovation in mechanical design, flow efficiency, and thrombus prevention.</p><p><strong>Method: </strong>A systematic review of 27 low-risk studies was performed on four axial flow LVADs: HeartMate II, DeBakey, Berlin Heart INCOR, and Jarvik 2000. The analysis evaluated durability and reliability using key metrics, including actuarial survival rates, device exchange rates, pump thrombosis rates, and freedom from adverse events, while considering technical factors such as rotor design, flow dynamics, and material innovation.</p><p><strong>Results: </strong>HeartMate II achieved a 79% actuarial survival rate at 1 year and a 6.3% thrombosis-related exchange rate. DeBakey had a higher exchange rate of 33.3% due to mechanical issues, indicating a need for better material durability. Jarvik 2000 offered long-term support with a 5-year duration and an 8.3% thrombosis rate, benefiting from its spiral cable design. INCOR showed high reliability with low energy consumption and minimal driveline infections, highlighting the advantages of advanced coatings and reduced friction.</p><p><strong>Conclusion: </strong>Axial flow LVADs are crucial for patients with small chest spaces, especially children. Enhancements in rotor design, materials, and real-time monitoring are essential for improving durability and reliability. These findings provide valuable insights for developing more durable and reliable axial flow pumps.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"343-362"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}