Evolution and current status of the total artificial heart: the search continues

Artificial hearts have been used for temporary and permanent replacement of failing human hearts. Attempts at permanent implantation during the 1980s were complicated by a high incidence of infection and thromboembolism, combined with a low quality of life for recipients. Given the success of cardiac transplantation, the artificial heart was relegated to temporary use in critically ill patients who were waiting for a donor heart. Continued difficulties with complications, combined with the success of ventricular assist devices for this purpose, dramatically reduced the use of the artificial heart. However, the recent development of compact electromechanical artificial hearts powered by transcutaneous energy systems has led to renewed hope for the possibility of permanent implantation. Some of these devices have been successful in animal studies and are approaching human trials. After years of hope and disappointment, artificial heart technology may be on the verge of efficacy. The history, status, and future of the artificial heart are discussed.