An overview of currently available circulatory assist devices (CADs) is presented with discussion of each system’s optimal use and limitations. Successful application of CAD technology for bridge to transplant or pending recovery of the natural heart requires understanding issues involving team readiness, patient selection, device limitations, patient management, and complications. Currently, many of these devices are in clinical trials with the Food and Drug Administration (FDA). The FDA and the National Institutes of Health play major roles in the ongoing development of this technology. In the near future the learning curve continues as totally implantable systems are used. The ultimate goal is to maintain patients with heart failure on implantable devices with a good quality of life at a reasonable cost

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