From mechanical circulatory support to artificial heart

various systems of mechanical circulatory support are now available : para-corporel devices, implantable ventricular assist devices, either portable or fully implantable. They, allow treatment in a wide range of clinical indications, from untractable cardiac failure to cardiogenic shock. They are used in 3 different intention to treat., bridging to transplantation, bridging to recovery or definitive permanent implant. They are progressively becoming efficacious alternatives to cardiac transplantation. Their efficacy has reduced the actual need for a total artificial heart, which nevertheless keeps few indications. Various problems technological, clinical, economical and ethical have to be solved before a wide application of the method.