Between September 1989 and June 1999, 228 patients were supported with a ventricular assist device as a bridge to heart transplantation. In this study, the results of implantation were evaluated in patients supported with one type of device, including 85 supported with a Thoratec, 61 with a Novacor, and 37 with a HeartMate. The mean support time was 49, 148, and 124 days, respectively. Successful transplantation and weaning rates were 64. 7% with Thoratec, 59.0% with Novacor, and 62.0% with HeartMate. Cerebral embolism and drive-line and pocket infection were major causes of postoperative morbidity and mortality. We recommended that a Thoratec system be employed as a bridge to heart transplantation for patients with biventricular heart failure, and that a Novacor or HeartMate system be implanted in patients requiring a long-term circulatory support.