As a critical treatment for patients with end-stage heart failure, artificial hearts have achieved significant clinical success. However, due to the direct contact between mechanical blood pumps and circulating blood, the clinical use of artificial hearts is often associated with blood damage-related complications such as thrombosis and bleeding, which significantly affect patient outcomes and prognosis. This paper first systematically reviews the mechanisms of blood damage induced by artificial hearts, including the biomechanical processes of platelet activation caused by non-physiological shear stress, von Willebrand factor (vWF) degradation, and platelet receptor impairment. Subsequently, existing thrombosis risk assessment models are summarized in detail, including blood stasis models, platelet activation models, and advanced mathematical models incorporating dynamic changes in coagulation factors and hemostatic proteins. These models predict high-risk thrombosis regions induced by artificial hearts, providing valuable guidance for device optimization and complication prevention. Finally, recently developed bleeding risk assessment models for artificial hearts are introduced. The integration of bleeding and thrombosis risk models enables the development of a more comprehensive hemocompatibility evaluation system. By reviewing the current research progress, this study aims to provide a reference for the assessment and prediction of blood damage in artificial hearts, contributing to improved hemocompatibility, enhanced safety, and better clinical outcomes of artificial heart devices.