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Here, we present a bioinspired passive flow routing approach that mitigates thrombosis by altering local hemodynamics to reduce stagnation, a primary hemodynamic driver of clot formation. Inspired by flow\u2010reattachment mechanisms in avian wings and aeronautical slats, we integrate circumferential routing channels into mechanical heart valve housings to redirect a small fraction of forward flow into peri\u2010ring regions prone to stasis. Computational optimization identifies a configuration that eliminates near\u2010zero\u2010shear pockets and reduces exposure to low shear by several orders of magnitude, while maintaining comparable high\u2010shear exposure relative to control under physiologic conditions. In a fibrin clot deposition assay, the routed design exhibits reduced peri\u2010ring clot accumulation. In an ovine bypass model without anticoagulation, the routed valve demonstrated improved sinus washout across angiographic assessments and, unlike the control, explant examination after three months showed no macroscopic thrombus at the sewing\u2010ring interface. Preliminary computational extensions indicate that passive flow routing can alleviate stagnation in additional cardiovascular geometries. These findings establish bioinspired passive flow routing as a hemodynamic design strategy to mitigate thrombosis in cardiovascular devices by targeting the hemodynamic root cause of stasis.<\/jats:p>","DOI":"10.1002\/advs.76344","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:25:11Z","timestamp":1783081511000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bioinspired Passive Flow Routing to Mitigate Thrombosis in Prosthetic Heart Valves and Cardiovascular Devices"],"prefix":"10.1002","volume":"13","author":[{"given":"Yevgeniy","family":"Kreinin","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Technion\u2013Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Epshtein","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Technion\u2013Israel Institute of Technology Haifa Israel"},{"name":"Department of Radiology New England Center for Stroke Research University of Massachusetts Medical School Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahel","family":"Talmon","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Technion\u2013Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tirosh","family":"Mekler","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Technion\u2013Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itay","family":"Or","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Rambam Health Care Campus Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahli","family":"Raad","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Rambam Health Care Campus Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Bolotin","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Rambam Health Care Campus Haifa Israel"},{"name":"The Ruth Bruce Rappaport Faculty of Medicine Technion\u2013Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8217-3842","authenticated-orcid":false,"given":"Josu\u00e9","family":"Sznitman","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Technion\u2013Israel Institute of Technology Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Netanel","family":"Korin","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Technion\u2013Israel Institute of Technology Haifa Israel"},{"name":"Fischell Department of Bioengineering University of Maryland, College Park  MD United\u00a0States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2305"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12961"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.09.958"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000503"},{"key":"e_1_2_11_6_1","article-title":"Management of Life\u2010Threatening Bleeding in Patients with Mechanical Heart Valves","volume":"13","author":"Huda S. 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