Two implantable continuous-flow ventricular assist devices in a biventricular configuration: technique and results†

Abstract

At the moment, there is a lack of a continuous-flow right ventricular assist device especially designed and approved for right ventricular support. Therefore, modifications in continuous-flow ventricular assist devices designed for the left ventricle are done to make them suitable for right ventricular support. However, more information is needed regarding the optimal surgical technique, patient selection and the optimal time point of implantation.

Durable Continuous-Flow Mechanical Circulatory Support: State of the Art

“…According to the results mentioned herein, a CF-RVAD for an on-label BiVAD configuration is greatly in need [41][42][43][44].…”

“…The total artificial heart (TAH) remains a viable alternative to BiVAD implantation. Studies have shown no difference in outcome between TAH vs. BiVAD thus far [1][2][3][4][5][6][7][8][9][10][11][12]24,[41][42][43][44]. However, it is also bulkier and more expensive, thus few centers have experience with its implantation and postoperative care compared with utilizing an additional LVAD.…”

“…Studies on CF-BiVADs are promising [41][42][43][44], and future progress will also accommodate this small but delicate cohort of biventricular failure patients while awaiting definitive transplantation. A dedicated CF-BiVAD device would additionally reduce to a single driveline and controller, thus decreasing infection risk and improving quality of life.…”

“…Additionally, in the near future, CF-LVADs that can perform the functions of total artificial hearts are likely to be developed [41][42][43][44].…”

Conventional and alternative sites for left ventricular assist device inflow and outflow cannula placement

“…Alternative sites, such as the descending thoracic aorta, supra-celiac abdominal aorta, innominate artery or subclavian arteries, have been described with acceptable results (6)(7)(8)(9)(10)(15)(16)(17).…”