**Abstract**

Indication of Ventricular assistance is advanced cardiac failure with maximal medical and surgical treatment has been used. The ventricular assistance has two main purposes: first, to maintain circulation by discharging the ventricle (s) untill to recovery, or to ensure patient survival by replacing cardiac function permanently or transitionally for patients waiting for heart Transplantation. The encouraging results of the partial or total artificial heart and the miniaturization of these devices allow their use in permanent implantation for patients with heart failure that is not eligible for heart transplantation. In left mono-ventricular assistance, blood is taken from the apex of the left ventricle (LV) and reinjected in the ascending aorta. The classic surgical approach is a total median sternotomy. Other minimally invasive approaches for the implantation or explanation of left ventricular assist devices have been published and have shown encouraging results. These alternatives currently play an important role in certain indications and in patients with heavy medical history. Nevertheless, the complications of the ventricular assistance even by minimally invasive approaches might be serious and represent a turning point in the life of the patients. In this chapter, we describe the implantation technique of left ventricular assistance device (LVAD) and we discuss its advantages and disadvantages including possible complications.

**Keywords:** minimally invasive, surgery, LVAD, implantation, complications
