Clinical translation and engineering challenges of soft robotic cardiac sleeves for heart failure

Soft robotic cardiac sleeves are an emerging class of non-blood-contact mechanical circulatory support devices designed to augment myocardial function while avoiding direct interaction with blood. Their development addresses important limitations of conventional heart failure therapies and offers a promising strategy for physiological cardiac assistance. This Review examines the pathophysiological basis for sleeve-assisted cardiac support, recent advances in soft robotic technologies, and the key engineering and translational challenges that must be overcome for clinical implementation. Finally, we propose a translational framework to guide the future development of clinically viable soft robotic cardiac sleeves. Heart failure remains a major cause of death despite advances in mechanical circulatory support. Here, the authors review soft robotic cardiac sleeves and define the key engineering, biological and translational challenges that must be addressed for successful clinical adoption.