There is increasing interest in developing wireless LVADs as a means to reduce the rate of infection and percutaneous cable fractures, and to improve quality of life. The Arrow LionHeart was the first and only completely implantable LVAD in clinical use. Percutaneous cables were eliminated by a transcutaneous energy transmission system (TETS) and implantable controller. Although this pulsatile LVAD was abandoned in favor of smaller rotary VADs, we retrospectively review the TETS technology and lessons learned regarding system design, implantation, reliability, and patient management, with implications for future systems. The LionHeart was implanted in a total of 40 patients, including 26 in the European trial and 10 in the US trial. It received the CE Mark in 2003. The TETS used double-tuned series-resonant coils, an operating frequency of 200 kHz, and was capable of transmitting 80 watts. The maximum coil separation was 2.5 cm axial and radial. Support time in the EU and US trials totaled 24.9 patient-years, 3.4 years maximum, 87 days median. Mean age was 64.2 +/−7.8 years. The LionHeart demonstrated high reliability; there were no failures of the TETS. There were two non-emergent implanted controller replacements due to gradual loss of implanted battery capacity. The implanted coils were well-tolerated. The coil site was moved from the lateral pectoral to the infraclavicular region to improve coil coupling stability. One patient died due to an unrecognized decoupling alarm. Decoupling also occurred in an obese patient. Patients resumed normal activities including bathing and swimming. A challenge for wireless LVAD designers is the reduction of a complex technology to an effective and safe user interface for clinicians, patients, and caregivers. Improvements were made in coil fixation, re-design of patient alarms, the level of user information, and batteries. This technology is easily adaptable to less complex and lower power systems.