Anatomic implantation technique for biventricular support with dual ventricular assist devices.

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.