The present invention provides a combined direct cardiac compression and aortic counterpulsation device comprising: an inflatable direct cardiac compression jacket configured when inflated to directly compress a heart and assist in displacing blood therefrom, an aortic counterpulsation chamber configured when inflated to displace aortic volume for the purposes of causing a counterpulsation effect, and a driver operably connected to said inflatable direct cardiac compression jacket and to said aortic counterpulsation chamber, said driver is configured to inflate said direct cardiac compression jacket and to deflate said aortic counterpulsation chamber during systole of the heart; said driver is further configured to deflate said direct cardiac compression jacket and to inflate said aortic counterpulsation chamber during diastole of the heart.