Transapical left ventricular bypass which withdraws blood directly from the left ventricular apex through a roller pump and outflow filter with return to the femoral artery has been applied in 6 patients with cardiac failure. All patients required total TALVB (with the aortic valve closed) for periods of one to 144 hrs, and 2 patients had recovery of life-sustaining myocardial function, allowing removal of the TALVB system. One patient had complete recovery without other organ dysfunction. Total TALVB continuously decompresses and unloads the left ventricle throughout systole and diastole, and maintains the circulation in otherwise terminal circumstances.