[Update Cardiac Support and Assist Therapies].

The management of acute and chronic heart failure utilizes various different techniques and medical devices. Different mechanical chest compression devices (mCPR), intraaortic balloon pump, catheter-based heart pumps like Impella, and different kinds of ECLS/ECMO are mainly used as bridge to recovery. Venovenous ECMO gained wide acceptance after the CESAR trial. Venoarterial ECMO plays an increasing role as extracorporeal CPR (eCPR). Newer concepts include venovenoarterial ECMO and the combination of ECMO and Impella. Principles and limitations of these concepts are discussed. Surgically implanted devices that include left and right ventricular assist devices (LVAD, RVAD), biventricular VADs and the total artificial heart (TAH) are commonly used as bridge to transplant or destination therapies. Quality of life must be considered in the use of the devices, as the life-saving devices come with restrictions in the patients' lives.