This issue of Cardiology Clinics, edited by Drs. Palak Shah and Jennifer Cowger, will focus on Mechanical Circulatory Support. Topics include, but are not limited to, The Evolution of Mechanical Circulatory Support, Continuous-flow Device Engineering and Pump Technology, Surgical Implantation: Perspective and Techniques, Temporary Circulatory Support and ECMO, Durable MCS Candidate Selection, Perioperative Management of the Right and Left Ventricle, Quality of Life, Frailty and Cognitive Impairment in the MCS Candidate, Microbiology and Infections in VAD recipients, Gastrointestinal Bleeding, Cerebrovascular Accident, Antithrombotic Strategies and Device Thrombosis, Impact of MCS on Post-Transplant Outcomes, Hemodynamic Pump-Patient Interactions & VAD Imaging, Ambulatory Patient Management, and Imaging in VAD recipients.