Biventricular assist devices and total artificial heart: Strategies and outcomes

Taiyo Kuroda; Chihiro Miyagi; Kiyotaka Fukamachi; Jamshid H Karimov

doi:10.3389/fcvm.2022.972132

Biventricular assist devices and total artificial heart: Strategies and outcomes

Front Cardiovasc Med. 2023 Jan 6:9:972132. doi: 10.3389/fcvm.2022.972132. eCollection 2022.

Authors

Taiyo Kuroda¹, Chihiro Miyagi¹, Kiyotaka Fukamachi^{1

2}, Jamshid H Karimov^{1

2}

Affiliations

¹ Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.
² Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, United States.

Abstract

In contrast to the advanced development of the left ventricular assist device (LVAD) therapy for advanced heart failure, the mechanical circulatory support (MCS) with biventricular assist device (BVAD) and total artificial heart (TAH) options remain challenging. The treatment strategy of BVAD and TAH therapy largely depends on the support duration. For example, an extracorporeal centrifugal pump, typically referred to as a temporary surgical extracorporeal right ventricular assist device, is implanted for the short term with acute right ventricular failure following LVAD implantation. Meanwhile, off-label use of a durable implantable LVAD is a strategy for long-term right ventricular support. Hence, this review focuses on the current treatment strategies and clinical outcomes based on each ventricle support duration. In addition, the issue of heart failure post-heart transplantation (post-HT) is explored. We will discuss MCS therapy options for post-HT recipients.

Keywords: HeartMate 3®; Impella®; ProtekDuo®; Syncardia® TAH; biventricular heart failure; heart transplantation; left ventricular assist device; right heart failure.

Publication types

Review