Three generations of left ventricular assist devices are available for the therapy of heart failure. In the current development, pulsatile devices are being displaced by axial flow pumps. Intentions for left ventricular assist device implantations are bridge to transplantation or to recovery and destination therapy. Already the mechanical support has the drop on the conservative medical therapy; furthermore, improvements in the devices are registered. In addition, by implanting a left ventricular assist device the quality of life was improved. Consequently, the importance of left ventricular assist devices in the therapy of heart failure is increasing.