Diamond-like carbon in ventricular assist devices

Abstract

Diamond-like carbon (DLC) coatings have become a prominent strategy to enhance the performance and hemocompatibility of ventricular assist devices (VADs). This review presents a comprehensive overview of the historical development of DLC coatings for VADs, the main DLC deposition techniques, types of blood pumps, substrate materials, and specific applications in VADs. DLC coatings, deposited via methods such as plasma-enhanced chemical vapor deposition, offer high hardness, chemical inertness, excellent wear resistance, and hemocompatibility, making them suitable for blood-contacting components in continuous-flow centrifugal pumps and continuous axial-flow pumps. The ability to apply DLC to various substrates, including metals and polymers, further broadens its biomedical utility. Comparative analysis with other hemocompatible coatings, such as heparin, titanium nitride, and 2-methacryloyloxyethyl phosphorylcholine polymers, demonstrates that DLC provides a unique balance of durability and blood compatibility, although challenges remain regarding long-term adhesion and stability. Advances in doped and nanostructured DLC films continue to improve antimicrobial and antithrombotic properties. Overall, DLC coatings represent a significant advancement in the quest for safer, longer-lasting VADs, but further research is needed to optimize their clinical performance and address remaining limitations.