Cardiovascular diseases are a leading cause of mortality, with limited possibilities for transplantation due to a critical shortage of donor hearts. Replacing the heart with total artificial hearts (TAHs) remains challenging, due to size constraints and energy requirements, among others. To address this, we introduce the LIMO heart, a compact TAH concept based on an efficient soft fluidic transmission system. By reducing actuator volume and enhancing energy transfer, LIMO enables a more compact and efficient design. We developed a soft ventricle prototype using thin-walled pouch actuators that achieve transmission ratios above one via circumferential shrinkage. A fast, cost-effective prototyping method accelerated testing. Experimental results showed high energy transfer efficiency (82 to 91%), and in vitro tests demonstrated promising cardiac outputs of 5.9 liters per minute against aortic pressure and 7.6 liters per minute against pulmonary pressure. These findings represent a step toward a more broadly applicable biventricular soft robotic TAH for treating end-stage heart failure.

Soft robots are intrinsically capable of adapting to different environments by changing their shape in response to interaction forces. However, sensory feedback is still required for higher level decisions. Most sensing technologies integrate separate sensing elements in soft actuators, which presents a considerable challenge for both the fabrication and robustness of soft robots. Here we present a versatile sensing strategy that can be retrofitted to existing soft fluidic devices without the need for design changes. We achieve this by measuring the fluidic input that is required to activate a soft actuator during interaction with the environment, and relating this input to its deformed state. We demonstrate the versatility of our strategy by tactile sensing of the size, shape, surface roughness and stiffness of objects. We furthermore retrofit sensing to a range of existing pneumatic soft actuators and grippers. Finally, we show the robustness of our fluidic sensing strategy in closed-loop control of a soft gripper for sorting, fruit picking and ripeness detection. We conclude that as long as the interaction of the actuator with the environment results in a shape change of the interval volume, soft fluidic actuators require no embedded sensors and design modifications to implement useful sensing.