DIAMOND-LIKE CARBON IN VENTRICULAR ASSIST DEVICES: HISTORY, TECHNIQUES, APPLICATIONS, AND HEMOCOMPATIBILITY

Authors

  • Rosa Corrêa Leoncio de Sá Universidade de São Paulo – Escola Politécnica – Departamento de Engenharia Metalúrgica e de Materiais – São Paulo (SP), Brazil|Instituto Nacional de Pesquisas Espaciais – Laboratório Associado de Sensores e Materiais – São José dos Campos (SP), Brazil|Instituto Federal de São Paulo – Laboratório de Bioengenharia e Biomateriais – São Paulo (SP), Brazil.
  • Tarcísio Fernandes Leão Instituto Federal de São Paulo – Laboratório de Bioengenharia e Biomateriais – São Paulo (SP), Brazil.
  • Evandro Drigo da Silva Instituto de Pesquisas Energéticas e Nucleares – Centro de Lasers e Aplicações – São Paulo (SP), Brazil.
  • Guilherme Barbosa Lopes Junior Instituto Federal de São Paulo – Laboratório de Bioengenharia e Biomateriais – São Paulo (SP), Brazil.
  • Breno Nishida Instituto Federal de São Paulo – Laboratório de Bioengenharia e Biomateriais – São Paulo (SP), Brazil.
  • José Ricardo Correa de Sousa Sobrinho Instituto Federal de São Paulo – Laboratório de Bioengenharia e Biomateriais – São Paulo (SP), Brazil.
  • Marco Antonio Ramirez-Ramos University of Texas – Department of Chemistry and Biochemistry – El Paso (TX), United States.
  • João Roberto Moro Instituto Nacional de Pesquisas Espaciais – Laboratório Associado de Sensores e Materiais – São José dos Campos (SP), Brazil|Instituto Federal de São Paulo – Laboratório de Bioengenharia e Biomateriais – São Paulo (SP), Brazil.
  • Evaldo José Corat Instituto Nacional de Pesquisas Espaciais – Laboratório Associado de Sensores e Materiais – São José dos Campos (SP), Brazil.
  • Vladimir Jesus Trava-Airoldi Instituto Nacional de Pesquisas Espaciais – Laboratório Associado de Sensores e Materiais – São José dos Campos (SP), Brazil.
  • Eduardo Guy Perpétuo Bock Instituto Federal de São Paulo – Laboratório de Bioengenharia e Biomateriais – São Paulo (SP), Brazil.

DOI:

https://doi.org/10.17563/rbav.v44i1.1275

Keywords:

Diamond-like carbon, Biomaterials for cardiology, Hemocompatibility, Ventricular assist devices, DLC coatings

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 continuousflow 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.

Downloads

Download data is not yet available.

References

1. Avezum A, Maia LN, Nakazone M. Cenário das doenças cardiovasculares no mundo moderno. In: Timerman A, Bertolami M, Ferreira JFM, editors. Manual de cardiologia. São Paulo: Atheneu; 2012. p. 1-5.

2. Bock E, Pfleging W, Tada D, Macedo E, Premazzi N, Sá R, et al. Laser-treated surfaces for VADs: from inert titanium to potential biofunctional materials. BME Frontiers. 2022. https://doi.org/10.34133/2022/9782562

3. Associação Brasileira de Normas Técnicas. NBR ISO 10993-1. Avaliação biológica de dispositivos médicos: avaliação e ensaios dentro de um processo de gerenciamento de risco. Rio de Janeiro: ABNT; 2022. 48 p.

4. Robertson J. Diamond-like amorphous carbon. Mater Sci Eng R Rep. 2002;37:129-281. Available from: https://universalvacuumtech.com/wp-content/uploads/Robertson-Diamond-Like-Amorphous-Carbon.pdf

5. Shah R, Pai N, Khandekar R, Chavan S, Sharma A, Joshi S, et al. DLC coatings in biomedical applications: review on current advantages, existing challenges, and future directions. Surf Coat Technol. 2024;131006. https://doi.org/10.1016/j.surfcoat.2024.131006

6. Peng Y, Peng J, Wang Z, Xiao Y, Qiu X. Diamond-like carbon coatings in the biomedical field: properties, applications and future development. Coatings. 2022;12(8). https://doi.org/10.3390/coatings12081088

7. Dearnaley G, Arps J. Biomedical applications of diamond-like carbon (DLC) coatings: a review. Surf Coat Technol. 2005; 200:2518-2524. https://doi.org/10.1016/j.surfcoat.2005.07.077

8. Malisz K, Świeczko-Żurek B, Sionkowska A. Preparation and characterization of diamond-like carbon coatings for biomedical applications: a review. Materials. 2023;16(9). https://doi.org/10.3390/ma16093420

9. Sin D, Kei H, Miao X. Surface coatings for ventricular assist devices. Expert Rev Med Devices. 2009;6(1):51-60. https://doi.org/10.1586/17434440.6.1.51

10. Zhang M, Tansley G, Dargusch M, Al-Jumaily AM, Al-Mousawi RF. Surface coatings for rotary ventricular assist devices: a systematic review. ASAIO J. 2022;68(5):623-632. https://doi.org/10.1097/MAT.0000000000001534

11. Sá RCL, de Andrade AJP, Salvadori MCB, Sá Teixeira F, Corat EJ, Moro JR, et al. Biofunctionalization of surfaces to minimize undesirable effects in cardiovascular assistance devices. Artif Organs. 2024;48(2):141-149. https://doi.org/10.1111/aor.14683

12. Oohira K. Characteristics and applications of DLC films. NTN Tech Rev. 2009;(77):90-95. Available from: https://www.ntnglobal.com/en/products/review/pdf/NTN_TR77_en.pdf

13. Moro JR, Trava-Airoldi VJ, Corat EJ, Leite NF. Reator de grande porte para crescimento de filme de diamante. Rev Bras Apl Vácuo. 1997;16:26-29. Available from: https://www.sbvacuo.org.br/rbav/index.php/rbav/pt_BR/article/view/285

14. Weiler M, Sattel S, Jung K, Ehrhardt H, Veerasamy VS, Robertson J. Highly tetrahedral, diamond-like amorphous hydrogenated carbon prepared from a plasma beam source. Appl Phys Lett. 1994;64:2797-2799. https://doi.org/10.1063/1.111428

15. Celi FG, Butler JE. Diamond chemical vapor deposition. Rev Química. 1991;42:643-684. https://doi.org/10.1146/annurev.pc.42.100191.003235

16. Derakhshandeh MR., Eshraghi MJ, Hadavi MM, Javaheri M, Khamseh S, Ganjaee Sari M, et al. Diamond-like carbon thin films prepared by pulsed-DC PE-CVD for biomedical applications. Surf Innov. 2018. https://doi.org/10.1680/jsuin.17.00069

17. Jing P, Zhang M, Chan C, Jing F, Pauls J, Dargusch M, et al. Diamond-like carbon films prepared by a low temperature periodic process for application in ventricular assist devices. J Biomed Mater Res B Appl Biomater. 2022; 111(5). https://doi.org/10.1002/jbm.b.35213

18. Birkett M, Zia AW, Devarajan DK, Soni B, Panayiotidis MI, Joyce TJ, et al. Multi-functional bioactive silver- and copper-doped diamond-like carbon coatings for medical implants. Acta Biomater. 2023;167. https://doi.org/10.1016/j.actbio.2023.06.037

19. Hasebe T, Shimada A, Suzuki T, Matsuoka Y, Saito T, Yohena S, et al. Fluorinated diamond-like carbon as antithrombogenic coating for blood-contacting devices. J Biomed Mater Res A. 2006;76(1):86-94. https://doi.org/10.1002/jbm.a.30512

20. Trava-Airoldi VJ, Corat EJ, Leite NF, Nóbrega BN, Baranauskas V. Crescimento de filmes de diamante utilizando tocha de oxigênio-acetileno. Rev Bras Apl Vácuo. 1992;11(2):36-40. Available from: https://www.sbvacuo.org.br/rbav/index.php/rbav/pt_BR/article/view/369

21. Capote G, Ramírez MA, Silva PCS, Lugo DC, Trava-Airoldi VJ. Improvement of the properties and the adherence of DLC coatings deposited using a modified pulsed-DC PECVD technique and an additional cathode. Surf Coat Technol. 2016;308:70-79. https://doi.org/10.1016/j.surfcoat.2016.08.096

22. Ramirez MA, Silva PC, Corat EJ, Trava-Airoldi VJ. An evaluation of the tribological characteristics of DLC films grown on Inconel alloy 718 using the active screen plasma technique in a pulsed-DC PECVD system. Surf Coat Technol. 2015; 284:235-239. https://doi.org/10.1016/j.surfcoat.2015.08.077

23. Zimpfer D, Gustafsson F, Potapov EV, Wieselthaler G, Pya Y, Krabatsch T, et al. Multicentre clinical trial experience with the HeartMate 3 left ventricular assist device: 30-day outcomes. Eur J Cardiothorac Surg. 2016;50(3): 548-554. https://doi.org/10.1093/ejcts/ezw169

24. Sheikh FH, Russell SD. HeartMate II® continuous-flow left ventricular assist device. Expert Rev Med Devices. 2011; (1):11-21. https://doi.org/10.1586/ERD.10.77

25. Salerno CT, Hayward C, Hall S, Goldstein D, Saeed D, Schmitto J, et al. HVAD to HeartMate 3 left ventricular assist device exchange: best practices recommendations. Eur J Cardiothorac Surg. 2022;62(1):ezac169. https://doi.org/10.1093/ejcts/ezac169

26. Scandroglio AM, Kaufmann F, Pieri M, Kretzschmar A, Müller M, Pergantis P, et al. Diagnosis and treatment algorithm for blood flow obstructions in patients with left ventricular assist device. J Am Coll Cardiol. 2016; 67(23): 2758-2768. https://doi.org/10.1016/j.jacc.2016.03.573

27. Ucar M, Ozkokeli M, Calik E, Kahraman H. Early thrombus formation in patient with HeartWare left ventricular assist device presenting with acute heart failure. J Saudi Heart Assoc. 2016;28(1):49-51. https://doi.org/10.1016/j.jsha.2015.06.003

28. Uriel N, Pak SW, Jorde UP, Jude B, Susen S, Vincentelli A, et al. Device thrombosis in HeartMate II continuous-flow left ventricular assist devices: a multifactorial phenomenon. J Heart Lung Transplant. 2014;33(1):51-59. https://doi.org/10.1016/j.healun.2013.10.005

29. Jorde UP, Yost G, Lam W, Kirklin JK, Stulak JM, Hanke JS, et al. The Society of Thoracic Surgeons INTERMACS 2023 annual report: focus on magnetically levitated devices. Ann Thorac Surg. 2024;117(1):33-44. https://doi.org/10.1016/j.athoracsur.2023.11.004

30. Siddiqi TJ, Khan SU, Nasir F, Patel UK, Usman MS, Mody P, et al. Utility of the CHA2DS2-VASc score for predicting ischemic stroke in patients with or without atrial fibrillation: a systematic review and meta-analysis. Eur J Prev Cardiol. 2022; 29(4):625-631. https://doi.org/10.1093/eurjpc/zwab018

31. Lopes Jr GB, Cabezas-Gómez L, Bock EGP, Gonçalves JCSI. Physiological stress modelling and hemolysis prediction for high shear stress flows using computational hemodynamics. J Appl Fluid Mech. 2021;14(4):1237- 1248. https://doi.org/10.47176/jafm.14.04.32211

32. Shah P, Cowger J, Pagani FD, Rogers JG, Atluri P, Aaronson KD, et al. Twelfth interagency registry for mechanically assisted circulatory support report: readmissions after left ventricular assist device. Ann Thorac Surg. 2022;113(3): 722-737. https://doi.org/10.1016/j.athoracsur.2021.12.011

33. Schmitto JD, Shaw S, Garbade J, Gustafsson F, Morshuis M, Zimpfer D, et al. Fully magnetically centrifugal left ventricular assist device and long-term outcomes: the ELEVATE registry. Eur Heart J. 2024;45(8):613-625. https://doi.org/10.1093/eurheartj/ehad658

34. Sobrinho JRC, Sousa JF, Souza M, Andrade J, Martins A, Santos M, et al. System proposal for supervision of critical adverse processes in patients with implanted ventricular assist devices. Appl Sci. 2024;14(24):11551. https://doi.org/10.3390/app142411551

35. Wachesk C, Seabra S, Santos T, Coelho A, Graeff CFO, Lepienski CM, et al. In vivo biocompatibility of diamondlike carbon films containing TiO2 nanoparticles for biomedical applications. J Mater Sci Mater Med. 2021;32:116. https://doi.org/10.1007/s10856-021-06596-6

36. Sá RCL, Ramirez M, Drigo E, Trava-Airoldi VJ, Leão TF, Moro JR, et al. Study of diamond-like carbon (DLC) coating in polycarbonate for circulatory assist devices. In: ASAIO 62nd Annual Conference; 2016; San Francisco, US.

37. Sá RCL. Pivot bearings of a ventricular assist device made of diamond-like carbon: durability evaluation. In: European-Latin-American Conference of Theoretical and Applied Mechanics (ELACTAM); 2019; Havana, Cuba.

38. U.S. Food and Drug Administration. Medtronic HeartWare Ventricular Assist Device (HVAD) System. FDA; 2023. Available from: https://www.fda.gov/medical-devices/cardiovascular-devices/medtronic-heartware-ventricularassist-

device-hvad-system

40. Xu L-C, Bauer JW, Siedlecki CA. Protein, platelet, and blood coagulation interactions with biomaterial surfaces. Colloids Surf B Biointerfaces. 2015;124:49-68. https://doi.org/10.1016/j.colsurfb.2014.09.040

Downloads

Published

2025-12-18