There are currently 4 main types of cardiac assist devices: centrifugal pumps, paracorporeal pneumatic assist devices, implantable ventricular assist devices, total artificial heart. Although the efficacy of centrifugal pumps remains limited, that of the other 3 types of assist devices has now been clearly demonstrated. The choice between these various devices depends on the severity of heart failure at the time of implantation, the univentricular or biventricular disease, the potential for recovery, the patient's morphology and obviously the device or devices available to the team concerned. The results essentially depend on early implantation.