The proceedings of the "Mechanical Circulatory Support"-meeting present new aspects of mechanical circulatory support, recent experience with MCS in newborns and children using specially developed small devices, and the results of long-term mechanical assistance. The ability of the myocardium to recover under pressure de-loading and reduced workload is discussed. All these topics open up new perspectives for the use of mechanical circulatory support, not only as a bridge to transplantation, but also as a definitive approach for treating patients with end-stage heart failure. Some of the concepts may even provide real alternatives to heart transplantation, these being sorely needed in light of the severe donor organ shortage. Regulatory a s well as ethical aspects of the extended use of mechanical circulatory support systems and new technical developments in the field are discussed by internationally distinguished experts.