P>The use of implantable ventricular assist devices for the treatment of advanced, decompensated heart failure as a bridge to heart transplantation has experienced considerable evolution over the past decade. Improvements in the management and prevention of serious adverse events, and introduction of new continuous-flow rotary pumps that are smaller, more durable, and associated with fewer serious adverse advents has expanded the use of this therapy to a larger population of patients for bridge to transplant indication. (J Card Surg 2010;25:455-461).