Andreas P Kourouklis, Xi Wu, Julius Kaemmel, Sanne Hertegonne, Srikanth Mairpady Shambat, Mihyun Lee, Christian Grossmann, Raphael Hagen, Daniel Fehr, Fabrizio Spano, Carolina Pietsch, Simone de Brot, Nikola Cesarovic, Qun Ren, Mathias Bonmarin, Miriam Weisskopf, Annelies S Zinkernagel, Evgenij Potapov, Volkmar Falk, Edoardo Mazza
{"title":"使用超柔性导线进行能量传递的耐用机械循环系统降低传动系统感染风险。","authors":"Andreas P Kourouklis, Xi Wu, Julius Kaemmel, Sanne Hertegonne, Srikanth Mairpady Shambat, Mihyun Lee, Christian Grossmann, Raphael Hagen, Daniel Fehr, Fabrizio Spano, Carolina Pietsch, Simone de Brot, Nikola Cesarovic, Qun Ren, Mathias Bonmarin, Miriam Weisskopf, Annelies S Zinkernagel, Evgenij Potapov, Volkmar Falk, Edoardo Mazza","doi":"10.1016/j.healun.2025.07.012","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Driveline infections (DLIs) pose a burden to heart failure patients supported by durable mechanical circulatory support devices (dMCSs). A major factor to DLI comes from the low mechanical compliance of drivelines, affecting wound healing. New drivelines that mitigate mechanical stress on skin may reduce the risk of DLI. We investigate macroscopic and microscopic effects of wires with low flexural stiffness on the risk of DLI.</p><p><strong>Methods: </strong>Prototypes equipped with ultra-flexible wires, due to their stranded metallic core and small diameter, were percutaneously implanted in an adult ovine model of DLI and subjected to electric conditions typical of dMCS operation. In the control (no bacterial inoculation, n=2 animals, follow-up period around 2 months) and inoculation (with Staphylococcus epidermidis, n=2 animals, follow-up period 1.5 months) study groups, the commercial dMCS drivelines and the prototypes were implanted at equivalent surgical sites of each animal. In the inoculation group, the surgical sites were infected with Staphylococcus epidermidis 2 weeks post-implantation.</p><p><strong>Results: </strong>Ultra-flexible wires showed flawless electromechanical performance, enabled fast recovery of skin redness in the first 2 weeks (p<0.05), and reduced inflammation (p<0.0001) at the exit site compared to commercial dMCS drivelines. After S. epidermidis inoculation at the exit site, ultra-flexible wires displayed reduced bacterial number (34 times lower) compared to commercial dMCS drivelines, avoiding internal biofilm formation and macroscopic signs of infection.</p><p><strong>Conclusions: </strong>Using small, ultra-flexible wires reduced wound size and mechanical stress at the exit site, strengthening barrier function and lowering the risk of DLI. The use of ultra-flexible wires may improve the quality and duration of life of patients supported with dMCS.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":" ","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Reducing driveline infection risk in durable mechanical circulatory support devices with ultra-flexible wires for energy transfer.\",\"authors\":\"Andreas P Kourouklis, Xi Wu, Julius Kaemmel, Sanne Hertegonne, Srikanth Mairpady Shambat, Mihyun Lee, Christian Grossmann, Raphael Hagen, Daniel Fehr, Fabrizio Spano, Carolina Pietsch, Simone de Brot, Nikola Cesarovic, Qun Ren, Mathias Bonmarin, Miriam Weisskopf, Annelies S Zinkernagel, Evgenij Potapov, Volkmar Falk, Edoardo Mazza\",\"doi\":\"10.1016/j.healun.2025.07.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Driveline infections (DLIs) pose a burden to heart failure patients supported by durable mechanical circulatory support devices (dMCSs). A major factor to DLI comes from the low mechanical compliance of drivelines, affecting wound healing. New drivelines that mitigate mechanical stress on skin may reduce the risk of DLI. We investigate macroscopic and microscopic effects of wires with low flexural stiffness on the risk of DLI.</p><p><strong>Methods: </strong>Prototypes equipped with ultra-flexible wires, due to their stranded metallic core and small diameter, were percutaneously implanted in an adult ovine model of DLI and subjected to electric conditions typical of dMCS operation. In the control (no bacterial inoculation, n=2 animals, follow-up period around 2 months) and inoculation (with Staphylococcus epidermidis, n=2 animals, follow-up period 1.5 months) study groups, the commercial dMCS drivelines and the prototypes were implanted at equivalent surgical sites of each animal. In the inoculation group, the surgical sites were infected with Staphylococcus epidermidis 2 weeks post-implantation.</p><p><strong>Results: </strong>Ultra-flexible wires showed flawless electromechanical performance, enabled fast recovery of skin redness in the first 2 weeks (p<0.05), and reduced inflammation (p<0.0001) at the exit site compared to commercial dMCS drivelines. After S. epidermidis inoculation at the exit site, ultra-flexible wires displayed reduced bacterial number (34 times lower) compared to commercial dMCS drivelines, avoiding internal biofilm formation and macroscopic signs of infection.</p><p><strong>Conclusions: </strong>Using small, ultra-flexible wires reduced wound size and mechanical stress at the exit site, strengthening barrier function and lowering the risk of DLI. The use of ultra-flexible wires may improve the quality and duration of life of patients supported with dMCS.</p>\",\"PeriodicalId\":15900,\"journal\":{\"name\":\"Journal of Heart and Lung Transplantation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-07-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Heart and Lung Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.healun.2025.07.012\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Heart and Lung Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.healun.2025.07.012","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Reducing driveline infection risk in durable mechanical circulatory support devices with ultra-flexible wires for energy transfer.
Background: Driveline infections (DLIs) pose a burden to heart failure patients supported by durable mechanical circulatory support devices (dMCSs). A major factor to DLI comes from the low mechanical compliance of drivelines, affecting wound healing. New drivelines that mitigate mechanical stress on skin may reduce the risk of DLI. We investigate macroscopic and microscopic effects of wires with low flexural stiffness on the risk of DLI.
Methods: Prototypes equipped with ultra-flexible wires, due to their stranded metallic core and small diameter, were percutaneously implanted in an adult ovine model of DLI and subjected to electric conditions typical of dMCS operation. In the control (no bacterial inoculation, n=2 animals, follow-up period around 2 months) and inoculation (with Staphylococcus epidermidis, n=2 animals, follow-up period 1.5 months) study groups, the commercial dMCS drivelines and the prototypes were implanted at equivalent surgical sites of each animal. In the inoculation group, the surgical sites were infected with Staphylococcus epidermidis 2 weeks post-implantation.
Results: Ultra-flexible wires showed flawless electromechanical performance, enabled fast recovery of skin redness in the first 2 weeks (p<0.05), and reduced inflammation (p<0.0001) at the exit site compared to commercial dMCS drivelines. After S. epidermidis inoculation at the exit site, ultra-flexible wires displayed reduced bacterial number (34 times lower) compared to commercial dMCS drivelines, avoiding internal biofilm formation and macroscopic signs of infection.
Conclusions: Using small, ultra-flexible wires reduced wound size and mechanical stress at the exit site, strengthening barrier function and lowering the risk of DLI. The use of ultra-flexible wires may improve the quality and duration of life of patients supported with dMCS.
期刊介绍:
The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.