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.