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Hemocompatibility of biomaterials in contact with the blood of patients is a prerequisite for the short- and long-term applications of medical devices such as cardiovascular stents, artificial heart valves, ventricular assist devices, catheters, blood linings and extracorporeal devices such as artificial kidneys (hemodialysis), extracorporeal membrane oxygenation (ECMO) and cardiopulmonary bypass. Although lower blood compatibility of materials and devices can be handled with systemic anticoagulation, its side effects, such as an increased bleeding risk, make materials that have a better hemocompatibility highly desirable, particularly in long-term applications. This review provides a short overview on the basic mechanisms of blood coagulation including plasmatic coagulation and blood platelets, as well as the activation of the complement system. Furthermore, a survey on concepts for tailoring the blood response of biomaterials to improve the hemocompatibility of medical devices is given which covers different approaches that either inhibit interaction of material surfaces with blood components completely or control the response of the coagulation system, blood platelets and leukocytes.

Unlike traditional actuators, such as piezoelectric ceramic or metallic actuators, polymer actuators are currently attracting more interest in biomedicine due to their unique properties, such as light weight, easy processing, biodegradability, fast response, large active strains, and good mechanical properties. They can be actuated under external stimuli, such as chemical (pH changes), electric, humidity, light, temperature, and magnetic field. Electroactive polymers (EAPs), called ‘artificial muscles’, can be activated by an electric stimulus, and fixed into a temporary shape. Restoring their permanent shape after the release of an electrical field, electroactive polymer is considered the most attractive actuator type because of its high suitability for prosthetics and soft robotics applications. However, robust control, modeling non-linear behavior, and scalable fabrication are considered the most critical challenges for applying the soft robotic systems in real conditions. Researchers from around the world investigate the scientific and engineering foundations of polymer actuators, especially the principles of their work, for the purpose of a better control of their capability and durability. The activation method of actuators and the realization of required mechanical properties are the main restrictions on using actuators in real applications. The latest highlights, operating principles, perspectives, and challenges of electroactive materials (EAPs) such as dielectric EAPs, ferroelectric polymers, electrostrictive graft elastomers, liquid crystal elastomers, ionic gels, and ionic polymer–metal composites are reviewed in this article.

Polymer smart materials are a broad class of polymeric materials that can change their shapes, mechanical responses, light transmissions, controlled releases, and other functional properties under external stimuli. A good understanding of the aspects controlling various types of shape memory phenomena in shape memory polymers (SMPs), such as polymer structure, stimulus effect and many others, is not only important for the preparation of new SMPs with improved performance, but is also useful for the optimization of the current ones to expand their application field. In the present era, simple understanding of the activation mechanisms, the polymer structure, the effect of the modification of the polymer structure on the activation process using fillers or solvents to develop new reliable SMPs with improved properties, long lifetime, fast response, and the ability to apply them under hard conditions in any environment, is considered to be an important topic. Moreover, good understanding of the activation mechanism of the two-way shape memory effect in SMPs for semi-crystalline polymers and liquid crystalline elastomers is the main key required for future investigations. In this article, the principles of the three basic types of external stimuli (heat, chemicals, light) and their key parameters that affect the efficiency of the SMPs are reviewed in addition to several prospective applications.

Laser soldering is a current biophotonic technique for the surgical recovery of the integrity of soft tissues. This technology involves the use of a device providing laser exposure to the cut edges of the wound with a solder applied. The proposed solder consisted of an aqueous dispersion of biopolymer albumin (25 wt.%), single-walled carbon nanotubes (0.1 wt.%) and exogenous indocyanine green chromophore (0.1 wt.%). Under laser exposure, the dispersion transforms into a nanocomposite due to the absorption of radiation and its conversion into heat. The nanocomposite is a frame structure of carbon nanotubes in a biopolymer matrix, which provides adhesion of the wound edges and the formation of a strong laser weld. A new laser device based on a diode laser (808 nm) has been developed to implement the method. The device has a temperature feedback system based on a bolometric infrared matrix sensor. The system determines the hottest area of the laser weld and adjusts the current supplied to the diode laser to maintain the preset laser heating temperature. The laser soldering technology made it possible to heal linear defects (cuts) in the skin of laboratory animals (rabbits) without the formation of a fibrotic scar compared to the control (suture material). The combined use of a biopolymer nanocomposite solder and a laser device made it possible to achieve a tensile strength of the laser welds of 4 ± 0.4 MPa. The results of the experiment demonstrated that the addition of single-walled carbon nanotubes to the solder composition leads to an increase in the ultimate tensile strength of the laser welds by 80%. The analysis of regenerative and morphological features in the early stages (1–3 days) after surgery revealed small wound gaps, a decrease in inflammation, the absence of microcirculatory disorders and an earlier epithelization of laser welds compared to the control. On the 10th day after the surgical operation, the laser weld was characterized by a thin cosmetic scar and a continuous epidermis covering the defect. An immunohistochemical analysis proved the absence of myofibroblasts in the area of the laser welds.

Currently, an urgent need in the field of wearable electronics is the development of flexible sensors that can be attached to the human body to monitor various physiological indicators and movements. In this work, we propose a method for forming an electrically conductive network of multi-walled carbon nanotubes (MWCNT) in a matrix of silicone elastomer to make stretchable sensors sensitive to mechanical strain. The electrical conductivity and sensitivity characteristics of the sensor were improved by using laser exposure, through the effect of forming strong carbon nanotube (CNT) networks. The initial electrical resistance of the sensors obtained using laser technology was ~3 kOhm (in the absence of deformation) at a low concentration of nanotubes of 3 wt% in composition. For comparison, in a similar manufacturing process, but without laser exposure, the active material had significantly higher values of electrical resistance, which was ~19 kOhm in this case. The laser-fabricated sensors have a high tensile sensitivity (gauge factor ~10), linearity of >0.97, a low hysteresis of 2.4%, tensile strength of 963 kPa, and a fast strain response of 1 ms. The low Young’s modulus values of ~47 kPa and the high electrical and sensitivity characteristics of the sensors made it possible to fabricate a smart gesture recognition sensor system based on them, with a recognition accuracy of ~94%. Data reading and visualization were performed using the developed electronic unit based on the ATXMEGA8E5-AU microcontroller and software. The obtained results open great prospects for the application of flexible CNT sensors in intelligent wearable devices (IWDs) for medical and industrial applications.

The creation of quick-reacting electrically conductive polymers for use as actuators driven by low electrical currents is now seen as an important issue. Enhancing the electrical conductivity of hydrogels through the incorporation of conductive fillers, like salts, can reduce the necessary actuating voltage. However, several important questions arise about how the type of salt chosen and its concentration will affect not only the activation efficiency of the actuators but also the structure of the hydrogels utilized. In this study, to enhance the electrical conductivity of the hydrogel and lower the necessary activation voltage of the hydrogel actuators, lithium chloride (LiCl) and sodium chloride (NaCl) were incorporated as conductive fillers into the polyvinyl alcohol (PVA) polymer matrix. To determine the deformation of actuators, as well as the activation and relaxation times and efficiencies during activation, linear actuators capable of being activated through extension/contraction (swelling/shrinking) cycles were developed and examined based on the LiCl/NaCl content, applied voltage, and frequency. The main finding is that the required actuating voltage was lowered by up to 20 V by adding an equal mass of salt in relation to the PVA mass content. With a load of around 20 kPa, it was observed that the extension deformation for PVA/NaCl-based actuators can achieve 75%, while in contraction deformation, can reach 17%. Additionally, for the PVA/LiCl-based actuators, the extension deformation can reach 87%, while during contraction deformation, it can reach 22%. The degree of swelling in the PVA/NaCl hydrogels was generally less than that in the PVA/LiCl hydrogels, which was associated with the finding that the actuators prepared from PVA/NaCl hydrogels delivered an output that was 10–15% lower than those made from PVA/LiCl hydrogels across different testing cycles. Furthermore, adding salt increases the degree of crosslinking, which can explain why increased crosslinking leads to reduced deformation when exposed to AC voltage. These actuators can find extensive use in soft robotics, artificial muscles, medical applications, and aerospace industries.

Background: Currently, left ventricular assist devices (LVADs) are a successful surgical treatment for patients with end-stage heart failure on the waiting list or with contraindicated heart transplantation. In Russia, Sputnik 1 LVAD was also successfully introduced into clinical practice as a bridge-to-transplant and a destination therapy device. Development of Sputnik 2 LVAD was aimed at miniaturization to reduce invasiveness, optimize hemocompatibility, and improve versatility for patients of various sizes. Methods: We compared hemolysis level in flow path of the Sputnik LVADs and investigated design aspects influencing other types of blood damage, using predictions of computational fluid dynamics (CFD) and experimental assessment. The investigated operating point was a flow rate of 5 L/min and a pressure head of 100 mm Hg at an impeller rotational speed of 9100 min−1. Results: Mean hemolysis indices predicted with CFD were 0.0090% in the Sputnik 1 and 0.0023% in the Sputnik 2. Averaged values of normalized index of hemolysis obtained experimentally for the Sputnik 1 and the Sputnik 2 were 0.011 ± 0.003 g/100 L and 0.004 ± 0.002 g/100 L, respectively. Conclusions: Obtained results indicate obvious improvements in hemocompatibility and sufficiently satisfy the determined miniaturization aim for the Sputnik 2 LVAD development.

Currently, the development of stable and antithrombogenic coatings for cardiovascular implants is socially important. This is especially important for coatings exposed to high shear stress from flowing blood, such as those on ventricular assist devices. A method of layer-by-layer formation of nanocomposite coatings based on multi-walled carbon nanotubes (MWCNT) in a collagen matrix is proposed. A reversible microfluidic device with a wide range of flow shear stresses has been developed for hemodynamic experiments. The dependence of the resistance on the presence of a cross-linking agent for collagen chains in the composition of the coating was demonstrated. Optical profilometry determined that collagen/c-MWCNT and collagen/c-MWCNT/glutaraldehyde coatings obtained sufficiently high resistance to high shear stress flow. However, the collagen/c-MWCNT/glutaraldehyde coating was almost twice as resistant to a phosphate-buffered solution flow. A reversible microfluidic device made it possible to assess the level of thrombogenicity of the coatings by the level of blood albumin protein adhesion to the coatings. Raman spectroscopy demonstrated that the adhesion of albumin to collagen/c-MWCNT and collagen/c-MWCNT/glutaraldehyde coatings is 1.7 and 1.4 times lower than the adhesion of protein to a titanium surface, widely used for ventricular assist devices. Scanning electron microscopy and energy dispersive spectroscopy determined that blood protein was least detected on the collagen/c-MWCNT coating, which contained no cross-linking agent, including in comparison with the titanium surface. Thus, a reversible microfluidic device is suitable for preliminary testing of the resistance and thrombogenicity of various coatings and membranes, and nanocomposite coatings based on collagen and c-MWCNT are suitable candidates for the development of cardiovascular devices.

A technology for the formation and bonding with a substrate of hybrid carbon nanostructures from single-walled carbon nanotubes (SWCNT) and reduced graphene oxide (rGO) by laser radiation is proposed. Molecular dynamics modeling by the real-time time-dependent density functional tight-binding (TD-DFTB) method made it possible to reveal the mechanism of field emission centers formation in carbon nanostructures layers. Laser radiation stimulates the formation of graphene-nanotube covalent contacts and also induces a dipole moment of hybrid nanostructures, which ensures their orientation along the force lines of the radiation field. The main mechanical and emission characteristics of the formed hybrid nanostructures were determined. By Raman spectroscopy, the effect of laser radiation energy on the defectiveness of all types of layers formed from nanostructures was determined. Laser exposure increased the hardness of all samples more than twice. Maximum hardness was obtained for hybrid nanostructure with a buffer layer (bl) of rGO and the main layer of SWCNT—rGO(bl)-SWCNT and was 54.4 GPa. In addition, the adhesion of rGO to the substrate and electron transport between the substrate and rGO(bl)-SWCNT increased. The rGO(bl)-SWCNT cathode with an area of ~1 mm2 showed a field emission current density of 562 mA/cm2 and stability for 9 h at a current of 1 mA. The developed technology for the formation of hybrid nanostructures can be used both to create high-performance and stable field emission cathodes and in other applications where nanomaterials coating with good adhesion, strength, and electrical conductivity is required.

The need to simulate the operating conditions of the human body is a key factor in every study and engineering process of a bioengineering device developed for implantation. In the present paper, we describe in detail the interaction between the left ventricle (LV) and our Sputnik left ventricular assist devices (LVADs). This research aims to evaluate the influence of different rotary blood pumps (RBPs) on the LV depending on the degree of heart failure (HF), in order to investigate energetic characteristics of the LV-LVAD interaction and to estimate main parameters of left ventricular unloading. We investigate energetic characteristics of adult Sputnik 1 and Sputnik 2 LVADs connected to a hybrid adult mock circulation (HAMC) and also for the Sputnik pediatric rotary blood pump (PRBP) connected to a pediatric mock circulation (PMC). A major improvement of the LV unloading is observed during all simulations for each particular heart failure state when connected to the LVAD, with sequential pump speed increased within 5000–10000 rpm for adult LVADs and 6000–13000 rpm for PRBP with 200 rpm step. Additionally, it was found that depending on the degree of heart failure, LVADs influence the LV in different ways and a significant support level cannot be achieved without the aortic valve closure. Furthermore, this study expands the information on LV-LVAD interaction, which leads to the optimization of the RBP speed rate control in clinics for adult and pediatric patients suffering from heart failure. Finally, we show that the implementation of control algorithms using the modulation of the RBP speed in order to open the aortic valve and unload the LV more efficiently is necessary and will be content of further research.