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How to Use Opera Browser on Oculus Quest 2 [Download & Install] Opera improves the browsing experience on the Oculus Quest 2








Oculus Quest 2 has an inbuilt browser, Oculus Browser, for surfing the internet.

Opera browser is a better alternative due to its extensive features that improve the immersive surfing experience in VR.

Sideloading on the Quest 2 is considered safe with the use of Sidequest.

True gamers use the best gaming browser: Opera GX

Opera GX is a special version of the famous Opera browser that is built specifically to fulfill gamer’s needs. Packed with unique features, Opera GX will help you get the most out of gaming and browsing everyday:

CPU, RAM and Network limiter with hot tab killer

Integrated with Twitch, Discord, Instagram, Twitter and Messengers directly

Built-in sound controls and custom music

Custom color themes by Razer Chroma and force dark pages

Free VPN and Ad blocker

Download Opera GX

Opera browser is one of the early adopters of Oculus Quest 2. The developer 49 build has integrated virtual reality by supporting a 360-degree video player.

Hence, this article will teach you how to harness your opera browser to enjoy the very best of VR with Oculus Quest 2.

Can you use a web browser on Oculus Quest 2?

Yes! The Oculus Quest 2 supports web browsers. It has an inbuilt Oculus browser that can be used to surf the web securely and privately. Furthermore, its privacy settings help protect user anonymity and browser history.

Also, chromium browsers have also integrated VR capabilities into their browsers. Hence, you can use web browsers like Opera on Oculus Quest 2.

Does Opera GX support WebVR?

Moreover, given it’s a gamer’s browser it includes additional useful features like Twitch and Discord integrations, CPU and RAM limiters for better performance, and more.

Opera GX

Enjoy the web in VR with dedicated and easy-to-configure support from Opera GX!

Free Visit website

How do I install Opera on Oculus Quest 2? 1. How to download Opera on Oculus Quest 2?

    Go to the official download page and install Sidequest on your PC.

    Then, go to the Oculus Quest website and sign up to be a developer.

    Input your card details and accept the terms and conditions.

    Enable the developer mode on the Oculus app on your mobile device.

    Then download the Opera browser app to your device and sideload it on Oculus Quest 2.

    2. How do you sideload in Quest 2?

    Alternatively, you can also sideload wirelessly following these steps.

    This is a better and faster way to sideload directly from the Oculus Quest 2. Although most users prefer the former approach.

    Is sideloading Oculus Quest safe?

    The simple answer is Yes. Sidequest is a secured platform to sideload on the Oculus Quest. It is safe as long as you install only the things offered on Sidequest.

    However, safety may be breached if you sideload third-party apps, hacked, or mods on the Quest.

    What browser does the Oculus Quest use?

    Expert tip:

    Also, there are Wolvic and Firefox Reality as alternative browsers that are recognized by the Oculus Quest 2. The Wolvic browser is built explicitly for virtual reality also.

    However, other Chromium-based browsers can be used on Oculus Quest with the right versions.

    What is the best browser for Oculus Quest 2?

    Based on our test, the Opera browser is the best browser for Oculus Quest 2. It has a functional VR-360 player that immerses users in a 360-degree video universe.

    Also, its feature-rich options such as direct VR playback, internal VPN, and open-source chromium support make it an ideal fit.

    However, there are other best browser alternatives for Oculus Quest 2 here. You can check them out to see which works best for you.

    ⇒ Get Opera

    How to open a browser on Oculus Quest 2?

    This will automatically open the browser and you can start surfing immediately.

    Using the Opera browser on the Oculus Quest 2 can really improve the browsing experience in virtual reality. Although there is an inbuilt browser, what Opera offers makes it rank as the best browser for the Oculus Quest.

    Further, a VPN can also prove to be an effective asset for Quest owners who are in restricted locations. So, you can check out our article on the best VPNs for Oculus Quest & Oculus Quest 2 here to bypass the restrictions easily.

    Also, our article on how to fix the charging issues on Oculus Quest may be helpful if you encounter the issue.

    Still experiencing issues?

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    How To Use Seagate Backup Plus On Mac? (2 Solutions)

    Home » Tips » How to Use Seagate Backup Plus on Mac?

    Do you love your Mac as much as I do? My Mac is my workplace. It contains every article I’ve ever written. It holds every photo I’ve ever taken, contact details for the people that matter to me, and recordings of the songs I’ve written. If something goes wrong, everything could disappear forever!

    That’s why I keep careful backups of everything that matters to me, and so should you. An easy way to do that is to copy it to an external hard drive. The right Mac app will make sure it happens automatically, and the right external hard disk makes it easy.

    Seagate makes excellent hard drives for backup purposes. In our roundup Best Backup Drive for Mac, we found that their drives were the best in two major categories:

    The Seagate Backup Plus Hub is the best external hard drive to keep at your desk. It requires a power source, offers two USB ports for your peripherals, has a maximum data transfer rate of 160 MB/s, and comes with 4, 6, 8, or 10 TB of storage.

    The Seagate Backup Plus Portable is the best external hard drive to carry with you. It’s powered by your computer, comes in a sturdy metal case, transfers data at 120 MB/s, and comes with 2 or 4 TB of storage.

    They’re Mac compatible and offer excellent value. I use them myself.

    Purchasing one is the first step in keeping your data safe. The second step is to set up your computer to reliably and automatically keep an up-to-date copy of your files. Unfortunately, Seagate’s Mac software is not up to the job—it’s terrible. How can Mac users back up their computers reliably?

    The Problem: Seagate’s Mac Software is Not Up to the Job

    A company that calls their hard drives “Backup Plus” is obviously serious about helping you back up your computer. Unfortunately, while their Windows program will perform full scheduled backups, their Mac app only mirrors certain files.

    Here’s how it’s described in the Seagate Toolkit User Manual:

    The Mirror activity lets you create a Mirror folder on your PC or Mac that is synced to your storage device. Whenever you add, edit, or delete files in one folder, Toolkit automatically updates the other folder with your changes.

    What’s the problem? While the Windows app automatically keeps a second copy of all of your files—they’re all protected—the Mac app doesn’t. It will only copy what’s in your Mirror folder; anything outside of that folder won’t be backed up.

    It also means that if a Mac user accidentally deletes a file, it will be deleted from the mirror. That’s not how a true backup should work. While Windows users would be able to recover the file if it was deleted in error, Mac users won’t.

    None of that is ideal. Neither is the fact that the software only works with certain Seagate drives, and not at all with products from other manufacturers. As a result, I recommend you don’t use this software for your backups. We’ll explore some alternatives below.

    In case you’d like to try Toolkit first, let’s briefly look at how to install and use it.

    Backing Up Mac with Seagate Toolkit

    Make sure your hard drive is plugged in, then install the software. You’ll find Seagate Toolkit for macOS on the Seagate Support web page.

    After installation, the app will run in your menu bar, waiting for you to configure it. Mirror Now places the mirror folder in the default location (your home folder). Custom allows you to choose where to locate the mirror folder.

    In my Toolkit tests, this is where I began to have trouble. Here’s what I did: first, I selected the Seagate drive I wanted to use to back up files.

    But because it’s already configured as a backup drive using different software, Toolkit refuses to use it, which is understandable. Unfortunately, none of my spare drives were made by Seagate, so the software refused to acknowledge them, and I couldn’t test it further.

    If you’re curious, you can find further information in the online user manual and knowledge base.

    Solution 1: Back Up Your Mac with Apple’s Time Machine

    So Seagate’s software doesn’t allow Mac users to create full, scheduled backups. How can you use your Backup Plus hard drive? The easiest way is with Apple’s own software.

    Time Machine comes preinstalled on every Mac. We found it the best choice for incremental file backups. I use the software on my own computer to backup to a Seagate Backup Plus external hard drive.

    An incremental backup stays up-to-date by only copying files that are new or have been modified since your last backup. Time Machine will do this and a lot more:

    It will create local snapshots as space permits

    It will keep multiple daily backups for the last 24 hours

    It will keep multiple daily backups for the last month

    It will keep multiple weekly backups for all previous months

    That means that each file is backed up multiple times, making it easy to get back the correct version of your documents and files if anything goes wrong.

    Setting up Time Machine is easy. When you first plug in an empty drive, macOS will ask you if you want to use it to back up with Time Machine.

    That gave me enough time to change the defaults if I wanted to. Options include:

    I can save time and space by deciding not to back up certain files and folders

    I can allow the system to back up while on battery power. That’s a bad idea because bad things can happen if the battery runs out halfway through a backup

    I can decide just to back up my own files, excluding system files and applications

    I decided to stay with the default setting and let the backup start automatically. Time Machine began by preparing the initial backup, which took about two minutes on my machine.

    Then the backup proper began: the files were copied to the external hard drive (in my case, an older Western Digital drive I had laying in a drawer). Initially, 63.52 GB needed to be backed up in total. After a few minutes, a time estimate was displayed. My backup was completed even faster than expected, in about 50 minutes.

    Solution 2: Back Up Your Mac with Third-Party Backup Software

    Time Machine is a good choice for Mac backups: it’s conveniently built into the operating system, works well, and is free. But it’s not your only option. Tons of alternatives are available. They have different strengths and may create different types of backups. One of these may meet your needs better.

    Carbon Copy Cloner

    Carbon Copy Cloner is a solid option for hard drive cloning or imaging. That’s a different backup strategy than Time Machine: instead of backing up individual files, it makes an exact copy of the entire drive.

    After the initial duplicate is made, Carbon Copy Cloner can keep the image up to date by backing up only the files that have been modified or newly created. The clone drive will be bootable. If anything goes wrong with your computer’s internal drive, you can boot from the backup and continue working. That’s convenient!

    Other features include:

    A “cloning coach” that warns of configuration concerns

    Guided setup and restore

    Configurable scheduling: hourly, daily, weekly, monthly, and more


    Shirt Pocket’s SuperDuper! v3 is a simpler, more affordable disk cloning application. Many of its features are free; the full app costs $27.95 and includes scheduling, smart update, sandboxes, and scripting. Like Carbon Copy, the clone drive it creates is bootable.


    Econ Technologies ChronoSync is a more versatile application. It can perform just about every type of backup you’re likely to need:

    It can synchronize your files between computers

    It can back up your files and folders

    It can create a bootable hard disk image

    However, it doesn’t offer cloud backup as Acronis True Image (below) does.

    Scheduled backups are supported. You can configure your backups to be performed automatically each time you attach a specific external drive. Incremental backups are supported, and multiple files are copied simultaneously to save time.

    The software costs a little more—$49.99 from the developer’s web store. A more affordable version can be purchased from the Mac App Store for $24.99. It’s called ChronoSync Express. It’s feature-limited and unable to create bootable backups.

    Acronis True Image

    Acronis True Image for Mac is the most expensive application in our roundup, starting with a $49.99/year subscription. It also offers more features than the other apps on our list.

    The base plan offers active disk cloning, and the Advanced plan (which costs $69.99/year) adds half a terabyte of cloud backup. You can download the software and purchase a subscription from the developer’s website.

    Mac Backup Guru

    MacDaddy’s Mac Backup Guru is an affordable app that creates a bootable clone of your hard drive. It offers three types of backup in total:

    Direct cloning


    Incremental snapshots

    Any changes you make to your documents are automatically synced. You can choose not to overwrite older backups so you can go back to an earlier version of a document.

    Get Backup Pro

    Finally, Belight Software’s Get Backup Pro is the most affordable third-party backup program on our list. You can purchase it for just $19.99 from the developer’s website.

    Like ChronoSync, several types are offered:

    incremental and compressed file backups

    bootable cloned backups

    folder synchronization

    You can backup to an external drive, network drive, DVD, or CD. Backups can be scheduled and encrypted.

    So What Should You Do?

    You’ve decided to protect your data by backing up your Mac, and as a first step, you got a Seagate Backup Plus external hard drive. If you’re a Mac user, do yourself a favor and ignore the software that came with the drive. It doesn’t offer the features you need.

    Instead, use an alternative. You already have Apple’s Time Machine installed on your Mac. It’s reliable, easy to use, and will keep multiple copies of every file so you can choose the version you want to get back. It works well, and I use it myself!

    Or you can choose a third-party app. These offer additional features and backup types. For example, Carbon Copy Cloner and others will create a bootable backup of your hard drive. That means if your main drive dies, rebooting from the backup will get you working again in minutes.

    Whichever software you choose, start today. Everyone needs a reliable backup of their important files!

    Opera One Browser Is Not Playing Videos: 5 Quick Ways To Fix It

    Opera One Browser Is Not Playing Videos: 5 Quick Ways to Fix It The file in cause is often corrupted or damaged




    If you are using Opera One, you may experience problems when playing videos on the internet.

    Problems like videos not playing or videos not loading can occur due to various reasons such as an outdated browser.

    Usually, a quick workaround would be to update your current browser version but if that doesn’t resolve the issue, follow this guide for more tips.

    Having problems with your current version of Opera One? Make sure your browser is up-to-date.

    Although many possible reasons lead to issues with your Opera One Browser, one of the fastest solutions is reinstalling your browser first

    (make sure you download the version from only verified sources).

    Here’s what Opera One can do:

    Optimize resource usage: Opera One uses your Ram more efficiently than other browsers

    Enhanced privacy: integrated and unlimited VPN

    Gaming pleasant: Opera GX is the first browser created specifically for gamers

    ⇒ Get Opera One

    The Opera One browser is one of the most popular browsers in the world. Unfortunately, things aren’t always smooth as it can sometimes cause issues for users. One of the most common problems with the browser is that it will not play videos.

    Sometimes Opera One crashes or freezes making it unusable. Video issues are one of the most common problems we see on the web. Most often, they’re caused by issues related to a browser’s HTML5 video implementation, which can be frustrating to debug.

    You will often get a message that says opera error loading media file could not be played, which means you cannot watch your intended video. If you are in a similar predicament, we have outlined some solutions to help you play videos on your Opera One browser again.

    If your Opera One browser is not playing Youtube videos or videos from other sites, below are some possible causes:

    Unsupported video format – One of the main reasons videos fail to load in Opera One is that the browser does not support the video format. The video file format could be incompatible with your device’s operating system or browser.

    The file is corrupted or damaged – If you have downloaded a video from the Internet, it may be corrupted or damaged. Delete it and try downloading another copy from another source.

    The video is restricted – Sometimes, you can’t watch videos on Opera One because the video contains DRM (digital rights management) restrictions that prevent playback on your device.

    Which browser is best for playing videos? 

    You can check out our selection of the best browsers to watch videos and find one that works for you.

    What can I do if Opera One browser is not playing videos? 

    If you’re using an old version of Opera Browser, then it might be possible that some bugs are present in it, causing the problem with videos in your browser.

    To fix this issue, you should update your Opera One browser version to the latest one available on the official website.

    Opera One

    Use the latest version for error-free browsing and seamless video streaming!

    Free Download Now

    2. Disconnect other devices

    If you have multiple devices connected to the internet, it is possible that one of them is causing issues with your video playback. Other devices on the same network may be hogging the bandwidth, making videos unplayable.

    Try disconnecting all other devices from the internet connection and see if that fixes the problem. If it works, you need to limit the number of devices streaming videos simultaneously or adjust the resolution rate.

    3. Disable hardware acceleration 4. Clear cache and cookies

    If the problem is with your internet connection, try resetting your router. This will help to eliminate any software issues with the router by restarting it. To do this, unplug the power cable from the back of the router for about 30 seconds and then plug it back in.

    Should the problem persist, it’s possible that you have an older router whose firmware hasn’t been updated in a while. This could cause issues when trying to stream video content, and you’ll find that your internet keeps disconnecting.

    In such cases, you can check for new updates by logging into your router’s admin panel. Alternatively, you can opt to purchase a high-performance router to avoid future problems.

    What does loading error mean?

    A loading error is a type of error that occurs when you are trying to load a website. It happens when the website is unavailable and cannot be displayed on your computer.  This is a common issue faced by all users and is mostly caused by connectivity issues.

    Common causes include:

    Not enough memory – If you have lots of apps installed on your device, this may cause a loading error. In this case, you need to uninstall some apps to free up space for others and then try loading the site again.

    Corrupted data – Sometimes, corrupted data in your device can cause this type of problem. In such cases, you will need a reliable antivirus program to scan your system immediately and ensure that no viruses are installed on your system. 

    Firewall settings – A computer firewall may block access to the website you’re trying to reach. Check whether your firewall is blocking access or temporarily disabling it and try again.

    Hopefully, you have been able to apply one or more of our recommended fixes, and you are back to playing videos on your Opera browser uninterrupted.

    You may also encounter an error where Opera is not responding but feel free to refer to our dedicated article on how to fix the issue.

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    How To Use Kids Mode In Microsoft Edge Browser

    Sometimes, Internet browsing by children can unknowingly land them on pages that aren’t kid-friendly or have inappropriate content. As such, their online experience should be monitored or done under some sort of supervision. Browsers that are equipped with Family Safety controls can help parents set the defaults based on age. Kids Mode in Microsoft Edge has such safety guardrails in place.

    How to use Kids Mode in Microsoft Edge

    Firstly, Internet safety for kids depends on parents being aware of internet safety risks and understanding how to help their children and teens avoid them. Setting clearly defined rules can help kids safely explore the web.

    Launch the Edge browser.

    Select Browse in Kids Mode.

    Select the age range for kids.

    Change Background and colors.

    Block or Grant Website Permissions.

    Manage Allowed sites in Kids Mode.

    Kids Mode in Microsoft Edge browser supports only kid-friendly content like custom browser themes, browsing based on an allow list, Bing SafeSearch set to strict, and a password requirement to exit.

    Select the Browse in Kids Mode option as shown in the image above. The good thing here is, you don’t need to be signed into the browser. However, signing in will allow the Kids Mode settings to sync across your devices.

    A new page will appear, informing you about the feature. You can skip it to proceed further.

    When prompted, select an appropriate age band to launch Kids Mode in:

    5-8 years

    9 and older

    The mode doesn’t require a child account or profile.  A new window for Kids Mode will open on the full screen.

    Here, you can change colors or modify the background.

    Select Choose background and colors, select a theme and hit the Done button. The changes you make to the themes in Kids Mode won’t apply to normal browsing windows.

    Proceeding further, you’ll need to grant website permissions in Kids Mode so that when a child visits a website not included in the allow list, he’ll run into a block page. Only the specific website link on the block page will be available in the browsing session.

    Note – You can only make changes to the allowed list when you’re outside of the Kids Mode browsing window.  For this, you’ll need to go to Settings and more, choose Settings and scroll down to the Family option under the left navigation menu.

    The switch to the Right pane and go to Manage allowed sites in the Kids Mode heading. Here, you can view the predefined list of kid-appropriate sites.

    The list follows the alphabetical order in naming convention. Add or remove sites, as desired.

    Lastly, until you exit Kids Mode, Microsoft Edge will continue to launch in Kids Mode. So, if you would like to browse in the normal mode, you’ll have exited the Kids Mode.’

    Select the Kids Mode icon at the top of the browser.

    Choose the Exit Kids Mode window.

    When prompted enter the device password. It is the same as the one used to unlock your computer.

    Once done, you’ll safely exit Kids Mode and can resume normal browsing. Bear in mind, if you close the window through the taskbar or Close button at the top of the browser, Microsoft Edge will ask for your device credentials.

    Kids Mode in edge browser is programmed to clear browsing data on exit, automatically. Besides, it also clears things like Cookies and other site data when Kids Mode is disabled.

    Related: How to block a website in Microsoft Edge.

    How To Install Xbmc On Apple Tv 2

    The excellent media center software XBMC has finally come to Apple TV 2, but beyond being a great media center, if you’re wondering why else you should care I’ll sum it up in one word: 1080p. Yes, using XBMC, you can unleash 1080p video playback on the $99 Apple TV2… the playback suffers from occasional choppiness on uncompressed bluray video, but hey it’s the first release, and could make the ATV2 the cheapest 1080p video playback device on the market.

    You’ll need the following to get started:

    Apple TV 2 (Amazon link) running iOS 4.1, iOS 4.2.1, or later

    Seas0npass to jailbreak the Apple TV 2 (Instructions to jailbreak are below)

    A micro-USB cable (this is used for the jailbreak and tethered boot)

    The IP address of your AppleTV

    Jailbreaking the Apple TV2

    The first thing you’ll need to do is to jailbreak your Apple TV, this is made remarkably easy with Seas0nPass, which is arguably one of the easiest jailbreak apps out there for any iOS hardware. If you’re familiar with the process of jailbreaking an iPhone this will be very familiar to you, here’s a quick overview:

    Download and launch Seas0nPass (Direct Download link)

    You’ll now want to connect the Apple TV to your computer using a Micro USB cable, and then put the AppleTV into DFU mode (follow instructions on the screen for this)

    Once in DFU, iTunes will launch and start to restore the Apple TV with the custom IPSW Seas0nPass created, this is how the jailbreak is actually installed

    After the AppleTV is jailbroken, you’ll need to disconnect it from your computer briefly and then perform what is called a tethered boot. This basically just means you have to assist the bootloader by connecting it to your computer and using Seas0nPass again, but this time selecting ‘Boot Tethered’ from the menu

    Follow the instructions to tethered boot your newly jailbroken AppleTV

    Now that your Apple TV2 is jailbroken, you can install the XBMC software onto it.

    Install XBMC on the AppleTV 2

    Installing XBMC is just a matter of using SSH to connect to the newly jailbroken ATV2 to download and install the software. Here are the instructions from the XBMC team:

    ssh [email protected] (fill in your own ATV IP address)

    When prompted for your password, enter ‘alpine’ if you haven’t changed it. Now you’ll want to install the XBMC software, execute each of these commands independently:

    Next use apt-get:

    apt-get update

    And finally, install the software:

    apt-get install org.xbmc.xbmc-atv2

    When XBMC has completed installing, your AppleTV’s built-in media manager FrontRow will restart itself and you will see XBMC in the list of options, just select it to launch XBMC.

    I haven’t had the chance to try this out myself yet, but apparently XBMC runs quite well. 720p video runs beautifully as expected, but some uncompressed 1080p videos have occasional stuttering and choppiness as you can see in the video below from Engadget. It’s possible that the stuttering may be resolved with future software updates that better optimize hardware acceleration:

    If you don’t have an Apple TV you can still setup a media center on any Mac by using Plex or XBMC. It’s simple, just download the software, grab an HDMI adapter and AUX cable, and your Mac is now a media center.

    Oh and while we’re on the topic of XBMC, perhaps less useful but still interesting is that it was also just released for iPhone and iPad. This too requires a jailbreak, and the XBMC app can be found via Cydia.


    Why Scientists Are Still On The Quest To Build An Artificial Heart

    This article is excerpted from Sian E. Harding’s book “The Exquisite Machine: The New Science of the Heart.“ It was originally featured on The MIT Press Reader.

    Nothing shows more clearly the perfect engineering of the heart than our own failed attempts to imitate it. This history of the total artificial heart is punctuated with both brilliant innovation and continual clinical failure. In 1962, John F. Kennedy challenged the scientific community to land a man on the moon and return him safely to Earth by the end of the decade. In 1964, cardiovascular surgeon Michael DeBakey persuaded President Lyndon B. Johnson to fund a program to develop the first functional self-contained artificial heart, launching a race to successfully make one before the moon landing. In 1969 both aims were apparently achieved, with the Texas Heart Institute implanting the first total artificial heart just three months before the launch of Apollo 11. However, while the moon landings have led to the Space Shuttle, Mars Rover, and International Space Station, and (despite a long lull) the newest aims to develop a moonbase to bring us to Mars, a reliable off-the-shelf total artificial heart is still just out of reach.

    At the outset, the artificial heart was aimed to be a lifetime replacement for the failing organ. This was a high bar to reach, since the first design had an external compressor with an air line through the skin into the patient’s body. Compressed air inflated and deflated Dacron pouches or sacs, which collapsed and expanded to displace blood from a surrounding sac. While having the compressor outside the body was useful, since the mechanical parts (which were most susceptible to wear) could be easily replaced, it would make for a bulky piece of equipment to be wheeled about with the patient. It was difficult to see how this could be given to a patient and expect them to live an even partly normal life for many years.

    However, the history of the artificial heart is also intertwined with that of the heart transplant. This was again only a hopeful dream in the early 1960s, but by 1967 cardiac surgeon Christian Baarnard in Capetown performed the first successful transplant. Now, the purpose of these first artificial hearts was changed. They did not need to be suitable for a lifetime; their purpose was to keep the patient alive until a transplant donor could be found. As with many highly experimental therapies, the first case was done on a patient who had run out of options. A 47-year-old man was being operated on to repair a huge aneurysm of the left ventricle that had thinned and swollen the heart wall. He was being supported by a heart-lung machine, which bypassed the heart and kept blood flowing through the body. However, he could not be weaned from the machine at the end of the operation as his heart was too weak. He desperately needed a transplant. Denton Cooley, DeBakey’s associate, offered him the new experimental total artificial heart and he accepted. The patient was kept stable with the new device for 64 hours until a matching donor heart was found and then transplanted.

    Only about 200 transplants are carried out in the UK each year despite more than 750,000 living with heart failure, and similar figures are seen worldwide.

    This seemed at first a triumph for the total artificial heart, but tragically the patient died 32 hours later from sepsis. Not only that but the device had damaged both the blood and the kidneys, and the walls of the expandable sacs were coated with blood clots. This heralded a series of problems that would continue to thwart the scientists and engineers wrestling with this procedure. Infections and sepsis are a continual challenge to any device where there is a wire that must permanently cross the skin. Devices that move the blood will alter its composition and the foreign surfaces will cause the blood to clot, resulting in strokes and blood breakdown. The first Jarvik heart, one of the next iterations, was implanted in five patients and one lived for 620 days. But two of the patients had severe strokes, and eventually all died of either sepsis or blood problems.

    Heart transplantation also had a shaky start, with Baarnard’s first patient dying after only 18 days. The first patient in the UK, whose transplantation was performed by cardiothoracic surgeon Donald Ross at London’s National Heart Hospital, survived for only 45 days, and the general success rate remained disappointing. The problem here was not the mechanics of the operation or the initial performance of the new heart. It was the mismatch of the immune system of the recipient to that of the donor heart. Even though the donor heart is matched as closely as possible to the patient with the major tissue types, the immune system must be suppressed to stop the heart being rejected. Drugs to suppress the immune system were not very sophisticated in the early days, but the development of ciclosporin in the early 1980s produced a revolution in immunosuppression that dramatically improved the success of heart transplantation. Now, it is a victim of its own success, with many more people in need of a transplant than there are donors. Only about 200 transplants are carried out in the UK each year despite more than 750,000 living with heart failure, and similar figures are seen worldwide. To fill this gap, scientists have been genetically modifying pigs to make their hearts compatible with the human immune system so that they can be transplanted to patients without being rejected. This has proved very complex and challenging, but first clinical transplants started in 2023.

    The success of heart transplantation, however, had reinvigorated the search for the total artificial heart, with the more achievable goal of keeping the patient alive until a donor is found, or “bridge to transplant” as it is called. For decades, the artificial heart technologies have improved through changes to more biocompatible materials, better valve design, and more efficient handling of blood flow. Successes have been achieved: one study saw 80 percent of patients on the artificial hearts surviving for over a year, and some for 6 years. The longest time a patient was supported to transplant was 1,373 days. But severe infectious complications were still common, and the goal of a complete “destination” therapy for artificial hearts was still a distant dream.

    Meanwhile, the urgent need to bridge to transplant had taken the technology in another direction. Rather than replacing the failing heart completely, the idea was to support it by assisting the blood flow. The ventricular assist device, or VAD, took blood out of the ventricle of the heart by a completely different route and pushed it into the aorta at high pressure. This added to the blood being ejected from the heart and thereby magnified the effective cardiac output. It also solved another problem encountered by the engineers of total artificial hearts — how to balance the right and left heart-blood flow. The amount of blood circulating in the left ventricle/body loop must be very close to that in the right ventricle/lung loop. With 100,000 beats a day, even a teaspoon of difference at each beat would add up to 500 liters of blood in the wrong place. The heart has evolved complex biological mechanisms to make sure this does not happen, but the engineers were having huge battles to try to do the same with feedback systems. For VADs, either the right (or more usually) the left ventricle can be independently supported, taking this problem away.

    Left ventricular assist devices, or LVADs, have produced a revolution in care for end-stage heart failure. More than 15,000 LVADs have now been implanted worldwide, and around a third of patients with end-stage heart failure are now supported on LVADs. The intention is usually to bridge the patients to transplant, but in fact the shortage of donor hearts means that patients can often stay on LVAD support for years. Survival rates of over 50 percent are seen at seven years, and there are reports of patients living up to 13 years on these devices. LVADs have therefore become by default a therapy in themselves. Again, technology has progressed, with newer LVADs performing better. A breakthrough idea was to stop imitating the heart, with its pulsing action, and move to constant flow of blood. Rotating paddles (impellers) push the blood along in a continuous motion, creating a smooth unbroken stream. This has the curious side effect of creating a patient without a pulse, which can be disconcerting for the unsuspecting physician as well as producing some unwanted side effects as the body adapts to the new flow. External battery packs are still an inconvenience and a source of infection, but systems are being developed that transfer energy transcutaneously (across the skin) based on induction (like domestic induction stoves). The LVAD units would still need a small, implanted battery in case of a temporary device failure — and it has been known for external battery packs to be snatched from patients by handbag thieves!

    The search for a completely implantable total artificial heart continues. Trying to develop external transcutaneous units to fully power the demands of the heart is the biggest barrier. Specifications for a total artificial heart require it to pump eight liters per minute of blood against a blood pressure of 110 mmHg. (The biological power storage molecule adenosine triphosphate [ATP] would be needed in quantities greater than half your body weight per day to power your own heart to do that, if ATP were not continually renewed in cells.) Compressors have been miniaturized to be more portable, but it has been a struggle to make them completely implantable. Here it seems that the VAD technology may hold a solution, dispensing with compressors altogether and using instead the impeller devices, with dual right and left VAD working together.

    Solutions seem tantalizingly close, but no one is anticipating an easy ride. The many failures over the years have certainly produced in scientists a humility and awe for the natural engineering of the heart.

    Sian E. Harding is Emeritus Professor of Cardiac Pharmacology in the National Heart and Lung Institute at Imperial College London, where she led the Division of Cardiovascular Sciences and the BHF Centre for Cardiac Regeneration. She is the author of “The Exquisite Machine,” from which this article is excerpted.

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