The artificial heart (TAH) has become a clinical reality as a bridging device to staged transplantation. In order to manage one of the limiting factors of transplantation surgery, namely the lack of donor hearts, the use of TAH as a bridging device will be important for the next years. Nevertheless the development of TAH as a permanent prosthesis should be increasingly intensified. Biocompatibility must be the main goal of production. For the present there is no material in sight which fulfills all requirements. It might be possible though, that progresses in the development of synthetic materials will result in non-thrombotic TAH, herewith eliminating the vulnerable spot of TAH.