In the short historical review the principal technical and pathophysiological approaches of the Czech total artificial heart (TAH) research are emphasized. Survival was endangered by arterial and venous hypertension, especially the central venous pressure (CVP) increase, mineralization of driving diaphragms, thromboembolization, and infection. By the appropriate combination of antihypertensive, antimineralization, and anticoagulation treatment and of measures against infection, the survival of the experimental calves was increased (the longest one was 314 days of pumping). Technical and constructional improvement of the blood pumps was another cause of successful experiments. All details are issued in the references.