Evolutions in Cardiovascular Implants—A Review of Past, Present, and Future

Cardiovascular disease (CVD) remains the leading cause of mortality worldwide, driving the continuous evolution of implantable cardiovascular therapies. Although early cardiovascular implants revolutionized the treatment of CVD, they are limited by restenosis, mechanical failure, poor biocompatibility, and inadequate tissue integration. These clinical limitations have driven the development of next-generation implants, with improved hemodynamic performance, regenerative potential, and long-term functionality. Advances in biomaterial science, tissue engineering, biosensors, wireless telemetry, flexible bioelectronics, and translational cardiovascular medicine have transformed cardiovascular implants from passive structural devices into biologically integrated and increasingly intelligent systems capable of interacting dynamically with the host cardiovascular environment. In this review, we summarize the historical evolution, current clinical applications, and emerging technologies of major cardiovascular implants. We further discuss key biological and engineering challenges limiting long-term clinical success and highlight future directions in regenerative biomaterials, smart bioelectronics, and personalized cardiovascular implants for next-generation cardiovascular therapy.