Anatomic implantation technique for biventricular support with dual ventricular assist devices

Abstract

Objective

Bridge-to-heart transplantation with a single HeartMate 3 (HM3) left ventricular assist device has been a proven solution for end-stage heart failure. Some patients require durable right ventricle support for poor baseline biventricular function. We have successfully used dual HM3s in a biventricular configuration to bridge patients to transplant.

Methods

This report discusses, in 8 straightforward yet detailed steps, our technique to implant 2 HM3 devices for dual-chamber support.

Results

In total, 45 successful implants with this configuration of dual HM3 devices have been performed, the greatest reported volume in North America. We supported 1 patient for more than 3 years with durable dual biventricular assist devices, and he was eventually bridged to heart transplantation. More than 50% of our dual biventricular assist device cohort has subsequently received heart transplantation.

Conclusions

Dual HM3 implantation is alternative form of durable biventricular support. Benefits include the length of bridge therapy, the potential for home discharge, enhanced rehabilitation capabilities, and weight loss. This single-center experience demonstrates that this technique can be used to successfully bridge a patient to heart transplantation.