Advanced heart failure leads to dysfunction across most organs systems which produce significant impairments in quality of life and functional capacity. While heart transplant remains the gold standard of care, left ventricular assist devices (LVAD) have emerged from their role as bridge therapy to destination therapy for an increasing number of patients. Therefore, a thorough examination of the types of devices and their benefits and limitations are necessary to understand the interaction between the remaining pathophysiology and additional treatment modalities. The purpose of this activity is to provide the learner with the basic knowledge required to understand the prevalence, complications and current therapeutic strategies to manage patients with heart failure.