Conclusion
Taken together it can be stated that VAD therapy has developed from a pioneer era towards a solid clinical option for an increasing number of patients. In times of decreasing numbers of available donor organs, mechanical circulatory support might not only be the future of surgical heart failure treatment but also its present. Nevertheless careful patient selection, meticulous surgical handling and post-operative treatment have to be performed at a very high level in order to improve clinical outcome. The future will tell us which devices will be the best for patients. Apart from that the increasing number of LVAD patients represents an increasing challenge for the social systems all over the world.