In the course of time, as a consequence of the heart transplantation programme which started up shortly after the Heart Institute opened, the ideal of a "Heart Failure Clinic" developed, i. e. of a clinic providing every diagnostic and therapeutic option for treating heart failure. At a clinic of this kind not only surgeons, but specialists in intensive-care medicine in particular, as well as specialized internists, cardiologists, pulmonologists, specialists in psychosomatic illnesses and engineers have to work hand in hand.

Up to 1988, Prof. Emil Sebastian Bücherl worked at the Westend Teaching Hospital. His scientific research focussed on the development of an artificial heart as a permanent replacement for the native heart. The Heart Institute made use of Professor Bücherl’s pioneering work and continued to develop it. In 1987, for example, a patient was successfully kept alive on one of these artificial hearts until a suitable donor heart could be found. In 1988, Professor Bücherl’s concept was taken over by the private entrepreneur, Guido Fehling, and the first ventricular assist devices in Europe were produced commercially under the name "Berlin Heart". In co-operation with this company, the first systems suitable for long-term support of children of all ages were developed. These are the only pediatric systems of this kind to be developed to date and have been put into successful application all over the world.

"Berlin Heart" is now the market leader in this field in Europe. In addition to the older pump versions, other innovative systems – so-called "axial flow pumps" – have been developed, and at the moment these represent state-of-the-art technology in providing permanent support for a weakened heart. The German Heart Institute in Berlin has performed more than 950 interventions using ventricular assist devices and artificial hearts, and is thus the clinic with the widest range of experience in this field worldwide.

With more than 1,500 heart transplantations, the German Heart Institute is Europe’s leading facility in this sector, achieving excellent long-term results – almost 60 % of the patients live longer than ten years after the operation and some longer than 20 years – unfortunately, many patients cannot be helped in time due to a shortage of donor organs.

This is one of the reasons why we have been turning our attention towards alternatives to transplantation. In addition to simply implanting artificial heart pumps, we have also been able to prove that even severely diseased hearts can fully recover if artificial pumps relieve them of their everyday load. This is one of the fascinating projects which we will be pursuing in the future. Another is the improvement of conventional surgery techniques on hearts for which, up to now, transplantation had seemed the only option. Over the years we have become increasingly successful in this sector, and have recently begun to integrate the concept of "regenerative medicine" using so-called stem cells.

Summarising, one can only repeat that the GHI has been a very successful project to create an institute capable of providing seriously ill patients with state-ofthe- art therapy at any particular point in time. With this objective in mind, over the years first-ever scientific and medical contributions in all branches of this field have been made, and very often the institute was the first in the whole world to introduce certain methods and procedures.

continuation