International guidelines recommend the intraaortic balloon pump (IABP) as an assist of the left ventricle. Assist devices other than the IABP have become available. To improve the overall treatment of patients with heart failure, basic knowledge of assist devices in referral department is crucial. The TandemHeart increases flow and decreases metabolic demands. Several complications have been reported. Technological advances during the last few years have produced a smaller assist device. The Impella Recover LP 2.5 has been proved safe and able to perform a flow increase of 2.5 l/min and decrease metabolic demands.