Improvement of Hemocompatibility in Passive Cardiovascular Implant Devices

ABSTRACT Cardiovascular disease (CVD) accounts for one‐third of global deaths, making it the most common among all causes of death. While the first‐line treatment arsenal includes lifestyle changes and pharmaceutical agents, these preventative strategies suffer from poor adherence and ineffectiveness in some patients. If the cardiac condition worsens, more invasive procedures involving surgery and cardiovascular device implantation are utilized. Cardiovascular devices, whether active or passive (depending upon the generation of flow by the device), are therefore a key component in the CVD treatment battery. Critically, the use of these blood‐contacting devices is accompanied by an integral challenge of how to fulfil the treatment purpose with minimal blood compromise. This review summarizes the main approaches for improvements in device hemocompatibility by careful material selection and surface modifications, with a particular focus on passive (non‐flow‐generating) devices. We first discuss the key chemical properties that underlie an optimal blood‐compatible material and surface, particularly surface chemistries that are hydrophilic, superhydrophobic, smooth, nanotextured, negatively charged, or drug‐loaded. We then exemplify the implementation of these principles in several established passive cardiovascular implant devices, including stents, catheters, vascular grafts, and heart valves.