The actual role of cardiocirculatory assistance in heart-failure treatment as destination therapy and bridge to life.

Patients with end-stage heart failure have poor quality of life and a poor prognosis, and are usually burdened by symptoms at rest, need for frequent hospital admissions, complex pharmacologic therapies, and 1-year mortality rate of about 50%. Therapeutic options are scarce and not amenable to all. Only few patients can be transplanted. In recent years, technological progress has made available mechanical devices capable of providing short/medium- and long-term circulatory assistance. Clinical evidence of long-term survival without device-related adverse events using latest-generation small axial pumps allows evaluation of its use in patients with contraindications or inaccessibility to transplantation.