Constant progress has been made over the years in order to improve the performance of mechanical circulatory support devices. After the introduction of portable blood pump systems into clinical practice, we now study the performance characteristics of totally implantable mechanical circulatory support systems which do not require percutaneous drive lines or percutaneous electrical wiring. As a matter of fact, transcutaneous energy transfer is now achieved by induction, and pump controller performance read-out and pump parameter adjustment is performed by telemetry. The indication for clinical use of such devices has to be evaluated carefully. Mainly patients in need of a heart transplant but having contraindications to move forward (advanced age, former neoplasm, persistent antibodies) have benefits from such devices as destination therapy.