[Current status of the use of the artificial heart and ventricular assist systems]

The state of the technical development of the mechanical assist systems and the artificial heart, respectively, guarantees a sufficient support of the circulatory system up to the improvement of the own heart function or to the possible heart transplantation. There is the necessity for the temporarily limited support of the heart, but also for the long-term one. Independent of the underlying etiology in acute conditions of cardiac failure in many cases the external supporting system may be sufficiently helpful. The antithrombotic therapy and the prophylaxis of infections demands particular carefulness. There is still no representable release for the long-term use of the hitherto available cardiovascular supporting systems. The question is controversial, whether then an experiment on patients or an already accepted therapeutic intervention is still taken into consideration. Essential prerequisites for the long-term use would be a full implantability of the systems in transcutaneous energy transmission, a further biologization of the blood-contacting materials, a clarification of the immune phenomena, a possibly automatic mode of action adapted to the need as well as a reliable strategy of antithrombotic therapy. The increased risk of infection should be taken into consideration.