When prolonged use of adjuvant therapy (positive inotropic agents, ventricular or atrial pacing), including intra-aortic balloon counter-pulsation, fails to achieve separation of patients with poor ventricular performance from CPBP the use of LHAD should be considered. The left heart assist device is a means of diverting a moderate portion of the systemic blood flow around the left ventricle. It provides hemodynamic stability until the left ventricle regains is effectiveness and capability as a pump. Nursing care of these patients requires the highest competence in clinical assessment based on a sound knowledge of the interrelatedness of body system and technical support devices. Nursing responsibilities include: careful observation of patient's clinical appearance and behavior, interpretation of data obtained from monitoring equipment, early recognition of physiologic deviations, and prompt initiation of appropriate nursing interventions.