Outcomes in Patients Bridged with Univentricular and Biventricular Devices in the Modern Era of Heart Transplantation

Joshua C. Grimm, Chris Sciortino, J. Trent Magruder, Samuel P. Dungan, Vicente Valero, Kavita Sharma, Ryan Tedford, Stuart Russell, Glenn J.R. Whitman, Scott C. Silvestry, Ashish S. Shah

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background. Biventricular support before orthotopic heart transplantation (OHT) has been shown to adversely affect short- and long-term outcomes, but the comparative effect of support type is largely unknown. This study determined the comparative effect of univentricular and biventricular support on survival in bridged patients after OHT. Methods. The United Network of Organ Sharing database was queried for adult patients bridged to OHT with a univentricular (left ventricular assist device [LVAD]), biventricular (biventricular assist device [BiVAD]), or total artificial heart ([TAH]) device between 2004 and 2012. Unconditional and conditional survivals were compared with the Kaplan-Meier method. Cox proportional hazards regression models were constructed to determine the risk-adjusted influence of support type on death. Results. Of the 4,177 patients identified, 3,457 (20.4%), 575 (3.4%), and 145 (0.9%) were bridged with an LVAD, BiVAD, and TAH, respectively. Unadjusted 30-day, 1-year, and 5-year estimated survival was greater in LVAD patients than in the BiVAD and TAH cohorts. After risk-adjustment, BiVAD and TAH were associated with an increased risk of death at all time points. Unadjusted and adjusted 5-year survival, conditional on 1-year survival, was worse, however, in only TAH patients. Conclusions. Patients with biventricular failure bridged to OHT with a TAH or BiVAD experience worse short- and long-term survival comparison with those with an LVAD. This difference is most likely due to an increase in early death and depends on the type of BiVAD device implanted.

Original languageEnglish (US)
Pages (from-to)102-108
Number of pages7
JournalAnnals of Thoracic Surgery
Issue number1
StatePublished - Jul 1 2016

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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