Department of Mechanical and Process Engineering, Institute for Mechanical Systems, ETH Zurich, Leonhardstrasse 21, 8092, Zurich, Switzerland.
Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Eur Biophys J. 2022 Mar;51(2):171-184. doi: 10.1007/s00249-021-01568-8. Epub 2021 Sep 3.
The primary aim of this article is to review the clinical challenges related to the supply of power in implanted left ventricular assist devices (LVADs) by means of transcutaneous drivelines. In effect of that, we present the preventive measures and post-operative protocols that are regularly employed to address the leading problem of driveline infections. Due to the lack of reliable wireless solutions for power transfer in LVADs, the development of new driveline configurations remains at the forefront of different strategies that aim to power LVADs in a less destructive manner. To this end, skin damage and breach formation around transcutaneous LVAD drivelines represent key challenges before improving the current standard of care. For this reason, we assess recent strategies on the surface functionalization of LVAD drivelines, which aim to limit the incidence of driveline infection by directing the responses of the skin tissue. Moreover, we propose a class of power transfer systems that could leverage the ability of skin tissue to effectively heal short diameter wounds. In this direction, we employed a novel method to generate thin conductive wires of controllable surface topography with the potential to minimize skin disruption and eliminate the problem of driveline infections. Our initial results suggest the viability of the small diameter wires for the investigation of new power transfer systems for LVADs. Overall, this review uniquely compiles a diverse number of topics with the aim to instigate new research ventures on the design of power transfer systems for IMDs, and specifically LVADs.
本文的主要目的是回顾通过经皮动力线为植入式左心室辅助装置 (LVAD) 供电所面临的临床挑战。实际上，我们提出了预防措施和术后方案，这些措施通常用于解决动力线感染这一主要问题。由于缺乏用于 LVAD 功率传输的可靠无线解决方案，因此新的动力线配置的开发仍然是旨在以破坏性更小的方式为 LVAD 供电的各种策略的前沿。为此，在改善当前护理标准之前，经皮 LVAD 动力线周围的皮肤损伤和破裂形成代表着关键挑战。因此，我们评估了 LVAD 动力线表面功能化的最新策略，其目的是通过引导皮肤组织的反应来限制动力线感染的发生率。此外，我们提出了一类功率传输系统，这些系统可以利用皮肤组织有效愈合短直径伤口的能力。为此，我们采用了一种新方法来生成具有可控表面形貌的薄导电丝，从而有可能最大限度地减少皮肤损伤并消除动力线感染的问题。我们的初步结果表明，这些小直径电线可用于研究 LVAD 等 IMD 的新功率传输系统。总体而言，本综述独特地汇集了大量主题，旨在为 IMD（特别是 LVAD）的功率传输系统设计激发新的研究工作。
