[What are the indications for ambulatory mechanical hart-assist devices for the left ventricle?]

Ambulatory mechanical left ventricular assistance has become a reality but clinical experience of long-term tolerance is limited for setting up a randomised trial comparing this technique with cardiac transplantation. On the other hand, it is justified in proposing this long-term circulatory assistance to a subgroup of patients on the waiting list for transplantation but who have little chance of being transplanted before irreversible multivisceral failure sets in. Some specific contraindications to left ventricular mechanical assistance should be respected. After implantation of a portable system, the possibility of being reinscribed on the waiting list for cardiac transplantation should be envisaged if the patient so wishes.