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The best treatment for patients with severe biventricular failure is heart transplantation. When a heart donor is not imminently available, long-term biventricular support as a bridge to transplant is the only realistic option. Total artificial heart (Syncardia, Tucson, AZ) and continuous flow durable biventricular assist device implantation are the two mid-term support options.1,2 Reports demonstrate comparable survival with total artificial heart and biventricular pump support as bridge to transplant.3,4 Although the left ventricular assist device implant technique is standardized, there are few right ventricular assist device (RVAD) surgical implant techniques described; both the right ventricle and the right atrium can be used for the pump implant.2,5 We describe a HeartWare (HW) (Medtronic, Fridley, MN) implant technique at the right atrium with pump fixation to the right anterior chest wall that prevents suction events and functions well until heart transplant occurs.

Right Ventricular Device HeartWare Implant to the Right Atrium with Fixation to the Chest Wall in Patient with Biventricular Support