The artificial heart - progress, problems, and further development.

The state of the art in the development of artificial heart research based on more than 100 own animal experiments and information from the other groups working in the same field is laid out. Consideration is given to a variety of special problems. The use of biomaterials (blood compatibility and mechanical strength and durability), the flow pattern in the pumps (clot formation), and special hemodynamical effects are discussed as well as different driving systems and percutane energy transmission (avoidance of infection). Respective measurements show the hemodynamics in the systemic and pulmonary circulation, especially the difficulties of the venous inflow and the regulation of the pumps. The effect of an active artificial atrium and new ways of computerized regulation using noninvasively measured parameters are described. Other pathophysiologic findings (lung, kidney, acid-base metabolism, gastrointestinal tract, blood) are dealt with according to their importance. The miniaturization of the driving system and new methods of energy supply necessary for a totally implantable artificial heart system, envisaged for the future, are also pointed out.