Healthy hearts produce a “wringing” motion that reduces wall stress and helps the ventricles empty more completely, an observation that dates back to the 17th century and is now common knowledge among clinicians and cardiac researchers. What is less widely appreciated—and only recently brought to light with the advent of modern imaging techniques—is the fact that diseased hearts often lose this ability. Indeed, recent studies indicate that changes in ventricular twist dynamics accompany a surprising variety of cardiac disease states, including myocardial infarction, ectopic excitation, ventricular dilatation, aortic valve stenosis, and ventricular aneurysms. All of these disorders have been shown to alter the natural twisting motion of the heart, lowering cardiac efficiency, and accelerating the disease process. Logically speaking, if the loss of ventricular torsion leads to increased wall stress and reduced stroke volumes, then it is reasonable to postulate that restoring torsion by mechanically turning the apex of the heart might act to reverse these effects and improve cardiac function. This is a simple notion, but it is also an exciting prospect. If this approach to cardiac assist proves to be safe and effective, it could serve as the basis for an entirely new platform technology that may be used for both short-term and chronic circulatory support without the hematologic complications associated with blood-contacting devices that currently dominate the market. There are several potential advantages of this approach. First, a torsion-based ventricular assist device (tVAD) could be applied quickly without the need for invasive cannulae or potentially dangerous and expensive anticoagulation drug therapy. Another key benefit is that tVAD operation could be stopped for brief or even extended periods of time without risking thromboembolic complications that preclude such on/off cycling in conventional blood pumps, which must be removed or replaced if stopped for more than a few minutes. Also of significance is the fact that the most costly components needed for acute tVAD support would be reusable, thus allowing hardware costs to be distributed over a large number of patients. Preliminary studies in both computer-simulated left ventricles and live animal hearts indicate that mechanical torsion of the cardiac apex has a significant positive effect on blood pressure and stroke volume, with 90 deg torsion more than doubling blood flow from both left and right ventricles in the experimental setting of severe heart failure [1]. Thus, there is strong incentive to expand upon these studies in order to determine the extent to which tVAD technology can be used to improve cardiac function in human heart failure patients.