Mechanical and Hemocompatibility Assessment of Selected Technologies for Prosthesis Connection with the Outflow Cannula Graft of the RH PED^® Pediatric Pulsatile Pump for Heart Support

Background: Heart failure in pediatric patients remains a major cause of morbidity and mortality, often associated with congenital heart defects and cardiomyopathies. Mechanical circulatory support (MCS) devices have emerged as critical therapeutic options, particularly as bridges to transplantation or recovery. The complexity of their use in children necessitates highly specialized solutions. This study aimed to evaluate the quality and performance of selected connection technologies between prosthetic vascular grafts and the outflow cannula of the Religa Heart PED^® pediatric pulsatile pump, with a focus on tightness, surface smoothness, and structural integrity. Methods: Mechanical testing was conducted on various connection types, including static tensile strength and long-term durability under pulsatile flow conditions with biological fluid analogs. Macro and microscopic evaluations assessed the surface quality and potential thrombogenic risks, biological testing encompassed permeability analysis in static and dynamic settings, and hemocompatibility was determined by acute thrombogenicity. Additionally, in vivo observations in a large animal model were used for final qualitative validation. Results: All connection types demonstrated sufficient mechanical strength, with no structural degradation or leakage observed in any samples following long-term testing. Thrombus formation was absent in adhesive connections with Dacron and polytetrafluoroethylene (PTFE) grafts but was observed in the mechanical connection with the PTFE prosthesis. In addition, in vivo studies confirmed the tightness, hemocompatibility, and mechanical stability of the adhesive connection with the Dacron prosthesis. Conclusions: The adhesive connection between the outflow cannula and a Dacron prosthesis demonstrated superior mechanical and biological performance, including resistance to thrombogenesis and hemolysis, as well as stable integration under in vivo conditions. This solution shows high potential for safe application in the Religa Heart PED^® system.