Artificial hearts: a century of innovation
pharmafile | August 9, 2026 | Feature | | cardiac surgery, medical technology, patient care, university research
By Professor Brian J Ford
Artificial heart technology has advanced through decades of scientific persistence, engineering innovation and clinical collaboration. As next-generation devices move closer to routine practice, their evolution highlights the long scientific, regulatory and translational pathway from laboratory concept to life-saving medical technology.
Cardiac surgery is being transformed by the introduction of the Total Artificial Heart (TAH). This is now a proven technology that has extended the lives of thousands of patients, primarily as a temporary support system for those awaiting a transplant. The research is at the forefront of cardiac medicine, yet it began further back in time than you might imagine. The very first artificial heart dates back almost a century.
A hundred years ago Elizabeth Morrow fell ill with rheumatic fever in New York. It caused severe mitral stenosis, and her sister Anne became increasingly concerned. As it happens, Anne’s husband was the most famous man in the world, Charles Lindbergh, and he became determined to find an answer. He realised that an artificial heart could theoretically take over blood circulation during surgery, and in 1930 Lindbergh was introduced to Alexis Carrel at the Rockefeller Institute. Carrel was a pioneer of vascular surgery and he directed Lindbergh’s original idea of a heart-bypass device toward a system for keeping isolated organs alive outside the body. Even though he could not save Elizabeth’s life, Lindbergh design a pulsating pump that could keep animal organs alive for several weeks.
The first heart-lung machine was also created a century ago in the Soviet Union. This was the autojektor, brainchild of Sergei Bryukhonenko, a physician in Moscow who showed it keeping alive a severed dog’s head for 3½ hours. The creature licked its nose, blinked and responded to sounds. These experimental adventures were to inspire the young Vladimir Demikhov, a Russian biology student, to create the world’s first artificial heart. He had worked as a servicing technician in a tractor factory and by 1937 he had used his knowledge of engineering to perfect the design of an implantable heart. He kept dogs alive for many hours, and so had proved the concept could work. By 1946 Demikhov could maintain dogs with an auxiliary heart for more than a month until, in 1951, he implanted the first orthotopic artificial heart in a dog.
News of the Russian experiments did little to affect progress in the West, until Willem Kolff began his research in 1957. Kolff had already invented an artificial kidney and at the Cleveland Clinic he and Tetsuzo Akutsu inserted a plastic cardiac pump into a dog in December 1957. Ninety minutes later the animal was still going strong. That was the spark that triggered Western research – the notion of a total artificial heart was no longer in the realms of pure fantasy.
In 1969 Denton Cooley installed a pneumatic heart in a desperately ill patient named Haskell Karp at St. Luke’s Episcopal Hospital in Houston, Texas, in a desperate bridge to keep him alive before a transplant heart would arrive. Although the media were delighted, the community of cardiac surgeons was not. Michael DeBakey later told me that the experimental heart, which he had helped design, had been inserted without permission. In the event, Karp survived on the artificial heart for more than 2½ days, before the transplanted donor heart was successfully implanted. He died shortly thereafter due to a post operative bacterial infection.
The major landmark event took place on 2 December 1982 at the University of Utah, where William DeVries stitched the Jarvik-7 artificial heart pump into the chest of Barney Clark, a Seattle dentist whose own heart was finished. The design had been perfected by young Robert Jarvik, a student working under Kolff’s watchful eye. Clark lived for 112 days, tethered to a clanking console the size of a washing machine. He suffered a succession of minor strokes and a series of bacterial infections, as the medical world watched, fascinated and slightly nonplussed. DeVries proved the point; a permanent mechanical heart had actually worked, after a fashion, for one-third of a year.
After that the story splintered. Some teams chased total replacement; others, more sensibly, developed left-ventricular assist devices that simply supplemented a failing heart rather than replacing it entirely. Continuous-flow pumps arrived, smaller and quieter, spinning blood like tiny turbines instead of thumping away like the pioneering pneumatic pumps. Today’s devices can keep patients going for years, some as a bridge to transplant, others as “destination therapy,” a euphemism meaning that, without their machine, they’ll die.
And the state of play today? The United States is the major centre for research and clinical trials, with institutions like the Cleveland Clinic, Penn State University, and companies like SynCardia/Picard Medical and BiVACOR at the forefront. France has CARMAT, there is Sweden’s Realheart, and the Netherlands’ Holland Hybrid Heart project, while Australia is a fast-developing hub, backed by the Australian government’s AUD 50 million investment and the Monash University-administered Artificial Heart Frontiers Program. It is at Monash that the Heart Hackathon was initiated, an international competition for student TAH designs.
In Britain it is students who are taking the lead. The University of Bath now has Team Bath Heart, whose student-led project is developing and refining a TAH. They have achieved international recognition, winning the first place at the Heart Hackathon for two consecutive years (2023 and 2024), plus the Most Advanced Design Award last year. Previous designs had been to design a male heart, which are over 25% larger than female hearts. In 2025, the Bath team focused on a device tailored for females, addressing a critical gap in cardiovascular research.
Durham University has meanwhile set up Durham Heart, another cutting-edge, student-led team dedicated to designing, prototyping, and testing a TAH. They have been invited to the finals of the Heart Hackathon and presented their work at the International Society for Mechanical Circulatory Support (ISMCS) conference. The UK also has other student groups such as Sheffield University’s Heartificial (formerly Heart of the North), which are also Heart Hackathon contestants.
Parallel research has been to support the left ventricle, leaving the heart intact. The HeartWare HVAD from Framingham, Massachusetts, was released nearly 20 years ago, and had limited success due to mechanical failure and thrombotic blockages. Abbott Medical in Illinois are manufacturing the HeartMate 3 with maglev support instead of mechanical bearings, and this has proved to be highly successful. Some 50,000 patients have been fitted with HeartMate devices, among them latterly the HeartMate 3 for which survival rates have been recorded up to 80% after three years. [1]
A century ago, Charles Lindbergh had a series of glass tubes and pulsating rubber valves created, hoping in vain to imitate the human heart and save his relative’s life. Now, the leading product is the SynCardia Total Artificial Heart (STAH) which has been installed in over 2,100 patients in some 27 countries. The longest someone has survived with this device is over 8 years. That implant took place at the IVDK Dedinje Hospital in Belgrade, Serbia, which leads the world in terms of long-duration TAH patient support.
From the patient’s point of view, it is not an unalloyed success; most have a constrained existence, and all are tethered to an external power supply. A total implantable artificial heart does not exist. The living heart is composed of pumps, valves, and a vascular system powered by metabolic energy released by those curious cardiomyocytes. Its engineered replacement comprises pumps, valves, and a tubular system powered by … a battery in a bulky box. The patient outside hospital needs a backpack the size of a rucksack weighing at least 6 kg. Until it can all be implanted, the truly complete artificial heart remains a distant hope for the future, and not a present reality.
[1] American College of Cardiology: https://www.acc.org/latest-in-cardiology/articles/2023/07/25/13/36/sustained-superiority-of-the-heartmate-3-lvad
- Professor Brian J. Ford is a leading research biologist and author, and an authority on the microscope. Honorary Fellow of the Royal Microscopical Society and the of Linnean Society of London, he has made original contributions in microscopy, haematology and microbiology, and is the author of numerous books and research papers published worldwide
This article featured in: August 2026 – The Pharmafile Brief
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