Bridge to cardiac transplantation: successful use of prosthetic biventricular support in a patient awaiting a donor heart

A 33-year-old man with dilated cardiomyopathy was successfully "bridged" to cardiac transplantation, with the use of left and right prosthetic ventricles. The prostheses supported the pulmonary and systemic circulations for 87 h, at which time they were removed and orthotopic transplantation was performed. Heart transplantation is the only viable long-term therapy for end-stage dilated cardiomyopathy. In the case of sudden decompensation in a patient who requires cardiac transplantation, if a suitable allograft is not immediately available, a system of prosthetic ventricles can be used to provide hemodynamic support until a donor organ is located. In addition, the use of a prosthetic ventricle or ventricles does not preclude the possibility of recovery of ventricular function, an option that is removed if a total artificial heart is used.