Long-term mechanical circulatory support in 2014: A real alternative to heart transplantation?

Cardiac transplantation remains the gold standard for end stage heart failure however results of long-term mechanical circulatory support have dramatically improved over the last 10 years. One should now clearly consider a left ventricular assist device as bridge to transplant or destination therapy in refractory isolated left heart failure. Mechanical biventricular support remains more challenging with lower survival and may be proposed as bridge to transplant. Correct patient's selection and appropriate follow-up are mandatory in such critical patients.