Total Artificial Heart vs Left Ventricular Assist Device and Biventricular Assist Device

Biventricular heart failure remains a challenging issue in patients with end-stage cardiomyopathy requiring mechanical circulatory support options. Also, the Achilles heel of durable left ventricular assist devices (LVADs) remains right ventricular failure that significantly impacts morbidity and mortality. With recent changes in the heart transplant allocation system, there has been major shifts in practice patterns in the use of extracorporeal membranous oxygenation (ECMO), temporary VADs, and durable VADs in the treatment of biventricular failure and strategies for bridge to heart transplantation. Direct comparisons between devices are often difficult to make as there is a learning curve both at the provider level and institution level for each of these devices and strategies. The field continues to rapidly evolve, and the application of artificial intelligence may further hasten this growth.