The progression of heart failure is accompanied by large number of comorbidities, frequent hospitalizations, deterioration in quality of life, higher health care costs of patients and the risk of death in each hospitalization. Although cardiac transplantation is the treatment, it is not available for all. While awaiting transplant, many patients require support with inotropic drugs, but these drugs cause progressive deterioration. Survival is limited when treated with these drugs as the wait for transplant is prolonged or not done. Developments in the management of patients in the end-stages of the heart failure allow the consideration of circulatory support devices as an alternative treatment even when the transplant is not option.; The aim of our study is to revise about circulatory support devices, progress and usefulness in the management of patients in the end-stage of heart failure.