Lifetime circulatory support must not be restricted to transplant centers.

Heart failure that does not respond to maximum medical management is a frightening and debilitating condition. The patients have poor quality of life and become progressively more dependent on hospital admissions for escalating medical therapy. Long-term circulatory support can provide symptomatic relief and improved survival for those who do not have access to cardiac transplantation. User-friendly blood pumps with proven durability already exist. Rotary blood pumps must be made available in centers other than those involved in transplantation. The mystique must be removed from this relatively simple intervention.