Résumé : The use of ventricular assist devices for the treatment of patients with end-stage heart failure represents a promising alternative to standard surgical and medical therapy. An increasing number of machines are available, from pulsatile to continuous-flow pumps, providing a choice of the most appropriate configuration for the given clinical presentation. Their uses as extracorporeal life supports have changed the management of acute cardiac failure. The excellent results when used as a bridge to transplant has led to the possibility of their use as definitive therapy. This article reviews the current state of ventricular assist devices, focusing on their classification and more recent surgical indications.