Cavitation in blood-contacting biomedical devices

Cardiovascular disease, coupled with the growing demand for advanced therapeutic interventions, has driven the development of more effective treatment strategies; medical devices that support or replace components of the cardiovascular system have become conventional for extending the lives of patients. When organic biological components interface with non-physiological engineered stopgaps, suboptimal interactions can impact device function, durability, and even propagate life-threatening complications through the advent of foreign material and flow conditions. Cavitation is one such non-physiological event; while uncommon, it can occur within these devices, causing damage to material surfaces, surrounding tissues, and circulating blood cells. This review presents a contemporary overview of cavitation in blood-contacting biomedical devices, focusing on the underlying mechanisms, cavitation-prone locations, cavitation impact, and mitigation strategies. This paper discusses possible solutions and outlook that would enhance the performance of medical devices and avoid adverse effects of cavitation with modified device designs, operational control, material innovation, and surface treatments (e.g., microstructures, coatings).