Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support. Surgical repair for these complications remains the therapy of choice; however, surgery may be associated with high operative risk in some patients. The purpose of this article is to discuss mechanical complications associated with LVAD therapy and interventional transcatheter therapies that have been used to solve these increasingly complex problems.