One of the greatest challenges in the development of artificial hearts is hemocompatibility, or the ability of the device to interact with blood without causing clots or destroying blood cells. When blood contacts synthetic surfaces like polyurethane or titanium, it can trigger the coagulation cascade, leading to thromboembolic events such as strokes. To combat this, engineers utilize advanced coatings and "computational fluid dynamics" (CFD) to ensure that blood flow within the device is smooth and lacks the turbulence that activates platelets.

Modern artificial hearts also employ "magnetic levitation" (MagLev) technology to suspend the internal rotor in a magnetic field. This eliminates mechanical friction and heat, which are major causes of "hemolysis"—the rupturing of red blood cells. To stay informed on the latest material sciences and surface treatments being used to enhance device longevity, one can refer to the Artificial Heart Market research. These technological refinements have significantly reduced the incidence of pump-related complications, allowing patients to remain on support for several years.

Furthermore, the design must account for "calcification," where mineral deposits build up on the flexible membranes of the pump over time. This can lead to stiffness and eventual mechanical failure. Researchers are currently experimenting with bioprosthetic materials—such as chemically treated bovine or porcine pericardium—to line the internal chambers of the artificial heart. These hybrid designs aim to "camouflage" the device from the immune system, mimicking the biological lining of a natural heart.