[Possibilities of using cardiovascular assist systems and the artificial heart]

The mechanical support of the cardiovascular circulation of the reversibly or irreversibly damaged natural heart is possible in a different way. Beginning with the balloon pulsation with limited haemodynamical efficacy the application of left-or right-ventricular assist-systems finally leads to the biventricular assistance, when there are signs of the global cardiac dysfunction and an ability of recovery the heart function is assumed. The trend to use assist-systems over longer periods is perceptible also in patients in terminal phases of chronic cardiac diseases. Thus the importance of artificial hearts is increasing which are to be regarded as biventricular assist-system in orthotopic position. For a short-time use the up to now developed blood pumps, drives and regulation units are suited in few centres of the world. The orthotopic implantation of artificial hearts permits as second step the transplantation of a suitable donor heart. The heart transplantation guarantees high success rates and a cardiac function adapted according need. The demands on the long-term implantation of artificial hearts are at present so high that the majority of the specialists at the present stage of the development has a sceptical attitude to the long-term use.