Improved blood compatibility of rotary blood pump Sputnik by new design and novel anticoagulant surface coatings

Acute and chronic heart failure are major challenges in modern medicine in the European Union, but also in the Russian Federation. While transplantation of donor hearts is the best solutions, but mostly not available for a specific patient, ventricular assist devices (VAD) as implantable axial pumps have provided solutions to keep patients alive. Because of the shortage of donor organs, VAD become often the only solution for patients and hence a destination therapy. Long-term application of VAD requires systemic anticoagulation, which decreases the risk of thrombosis but increases that of bleeding. Moreover, the design of VAD bears risk of shear-induced damage of blood components, but also in-device thrombosis due to insufficient blood compatibility of metallic pump components. Hence, the proposal seeks to develop a new axial blood pump called SPUTNIK by the partner MIET that shall possess an optimized design to reduce shear-induced damage of blood cells and von Willebrandt factor. Since the blood compatibility of pump components made of titanium alloys needs to be improved, the partner MLU will develop a new durable anticoagulant surface coating that is based on a combination of covalently and adsorptive immobilization of heparin. The in vitro blood compatibility shall be studied with human blood components focusing on coagulation and platelet activation. The hemodynamic properties of the novel axial blood pump will be studied by MIET in a mock circulation approach that will also serve to study blood damage regarding hemolysis, von Willenbrandt factor damage, hemostasis and platelet activation. Design changes of pump geometry and surface coatings may contribute to an improved long-term blood compatibility that may permit VAD application in future settings as destination therapy in chronic heart failure.