Mechanical circulatory support (MCS) devices are designed to perform the functional needs of organs and to meet clinical hemocompability criteria. Critical complications have been reported with their long-term use such as thrombosis, anemia and gastrointestinal bleeding. Damage to red blood cells (RBCs), which occurs with nonphysiological blood flow conditions such as contact with foreign surfaces, high shear stress, and turbulence, is a major problem for the design and development of these systems. Even in the absence of hemolysis, cardiovascular devices (CAD) still cause cell injury and shortened RBC lifespans. This review summarizes various effects that occur to erythrocytes exposed to supraphysiological but sublethal stresses.
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