Inclusion Criteria:
* Age ≥ 18 years and ≤ 75 years
* The patient has signed an Informed Consent Form
* Body Surface Area (BSA) ≥ 1.2 m2
* New York Heart Association (NYHA) Class IV
* Left Ventricular Ejection Fraction (LVEF) ≤ 25%
* Despite the optimal medical management based on current guidelines, the patient must also meet one or more of the following:
* \- - a. Unable to exercise for HF, or if able to perform cardiopulmonary testing, with peak VO2 \<12 mL/kg/min and/or \< 50% predicted value;
* \- - b. Progressive end-organ dysfunction (worsening renal and/or hepatic function, type II pulmonary hypertension, cardiac cachexia) due to reduced perfusion and not to inadequately low ventricular filling pressure (PCWP \> 20 mmHg and SBP \< 90 mmHg or CI \< 2.0 L/min/m2).
* \- - c. Impella or IABP assisted; Inotrope dependent/unable to wean from inotropes.
Exclusion Criteria:
* Heart failure who can be treated with other therapy options (e.g. CRT, CRT-D, etc.)
* Intolerance to anticoagulant or antiplatelet therapies or any other peri/post-operative therapy the investigator will require based upon the patients' health status.
* Patient has known hypo or hyper coagulable states such as disseminated intravascular coagulation and heparin induced thrombocytopenia type II.
* Platelet count \< 100,000 x 103/L (\< 100,000/ml).
* Psychiatric disease/ disorder, irreversible cognitive dysfunction or psychosocial issues that are likely to impair compliance with the study protocol and left ventricular assist system management.
* Technical obstacles which pose an inordinately high surgical risk, in the judgment of the investigator.
* Presence of an active, uncontrolled infection.
* Presence of any one of the following risk factors for indications of severe end organ dysfunction or failure:
* \- - a. Total bilirubin \> 51.3 umol/L (3.0 mg/dl), ischemic hepatitis, or biopsy proven liver cirrhosis, or clinically Child-Pugh B and C score.
* \- - b. History of severe chronic obstructive pulmonary disease (COPD) defined by FEV1/FVC \< 0.7, or FEV1 \< 50% predicted.
* \- - c. Fixed pulmonary hypertension with a most recent PVR ≥ 8 Wood units that is unresponsive to pharmacologic intervention.
* \- - d. History of stroke within 180 days prior to enrollment, or a history of cerebrovascular disease with symptomatic (\> 70%) carotid artery stenosis
* \- - e. Serum creatinine ≥ 265umol/L (3.0mg/dl) or requiring dialysis.
* \- - f. Significant peripheral vascular disease (PVD) accompanied by rest pain or extremity ulceration.
* Etiology of heart failure (HF) due to or associated with uncorrected thyroid disease, obstructive/ restrictive cardiomyopathy, pericardial disease, amyloidosis or giant cell myocarditis.
* Uncorrected moderate to severe aortic insufficiency without plans for correction during pump implant.
* History of confirmed, untreated abdominal aortic aneurysm (AAA) or thoracic aortic aneurysm (TAA) \> 5 cm in diameter.
* Uncontrollable ventricular tachyarrythmias / ventricular fibrillation (VF).
* STEMI \<2 weeks before planned implantation.
* Right ventricular failure as defined by one or more of the following:
* \- - a. Severe depressed RV function in echocardiography
* \- - b. TAPSE \< 1.0 cm
* \- - c. CVP/PCWP ratio \> 0.63
* Planned Bi-VAD support prior to enrollment.
* Cardiac arrest with a history of resuscitation 1-month before inclusion, without full restoration of cognitive function.
* History of any organ transplant.
* Pre albumin \< 150 mg/L, or Albumin \< 30g/L (3 g/dL).
* Any condition other than HF that could limit survival to less than 24 months
* Positive pregnancy test if of childbearing potential.
* Lactating mothers.
* Participation in any other clinical investigation that is likely to confound study results or affect the study.
* Patients who have been placed in an institution by court order or by order of the authorities.
