Surface Coatings for Rotary Ventricular Assist Devices: A Systematic Review

Rotary ventricular assist devices (VADs) are frequently used to provide mechanical circulatory support to patients suffering from end-stage heart failure. Therefore, these devices and especially their pump impeller and housing components have stringent requirements on wear resistance and hemocompatibility. Various surface coatings have been investigated to improve the wear resistance or hemocompatibility of these devices. The aim of the present systematic review was to build a comprehensive understanding of these coatings and provide potential future research directions. A Boolean search for peer-reviewed studies was conducted in online databases (Web of Science, Scopus, PubMed, and ScienceDirect), and a preferred reporting items for systematic reviews and meta-analyses (PRISMA) process was followed for selecting relevant papers for analysis. A total of 45 of 527 publications were included for analysis. Eighteen coatings were reported to improve wear resistance or hemocompatibility of rotary VADs with the most common coatings being diamond-like carbon (DLC), 2-methacryloyloxyethyl phosphorylcholine (MPC), and heparin. Ninety-three percent of studies focused on hemocompatibility, whereas only 4% of studies focused on wear properties. Thirteen percent of studies investigated durability. This review provides readers with a systematic catalogue and critical review of surface coatings for rotary VADs. The review has identified that more comprehensive studies especially investigations on wear properties and durability are needed in future work.