title: Biventricular mechanical support devices--clinical perspectives.
abstract: Cardiac transplantation remains the optimal treatment for end stage heart failure in selected patients. However, the shortage of donor hearts, rigorous eligibility criteria and long waiting lists have increased the demand for alternative treatment strategies such as mechanical circulatory support. While many patients are adequately supported with left ventricular assist devices, frequently there is right heart failure or involvement of the right ventricle, requiring biventricular support. Pulsatile flow biventricular devices and total artificial hearts approved for temporary biventricular support have limitations including size, high rates of adverse events and restricted mobility which makes them unsuitable for long term support. A number of centres have reported dual continuous flow left ventricular assist devices as a means of supporting the left and right heart. This review will summarise the literature on the outcomes and complications from current biventricular support devices and assess the role of dual continuous flow VAD therapy, and the new continuous flow total heart replacement devices.
authors.affiliation: a Centre for Cardiovascular & Chronic Care, Faculty of Health , University of Technology , Sydney , Australia.|b Cardiology Department , St. Vincent's Hospital , Darlinghurst , Australia.
authors.forename: Sajad
authors.initials: S
authors.lastname: Shehab
authors.affiliation: a Centre for Cardiovascular & Chronic Care, Faculty of Health , University of Technology , Sydney , Australia.
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Newton
authors.affiliation: a Centre for Cardiovascular & Chronic Care, Faculty of Health , University of Technology , Sydney , Australia.
authors.forename: Sabine M
authors.initials: SM
authors.lastname: Allida
authors.affiliation: b Cardiology Department , St. Vincent's Hospital , Darlinghurst , Australia.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Jansz
authors.affiliation: b Cardiology Department , St. Vincent's Hospital , Darlinghurst , Australia.|c Victor Chang Cardiac Research Institute , Darlinghurst , Australia.|d Faculty of Medicine , University of New South Wales , Kensington , Australia.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hayward
mesh_terms: D006352:Heart Ventricles; D006353:Heart-Assist Devices; D006801:Humans; D011673:Pulsatile Flow
keywords: BiVAD; Biventricular assist device; chronic heart failure; continuous flow pumps; mechanical circulatory support; ventricular assist device