Table 5. Results—secondary outcomes.
| Paper | ICU-LOS/H-LOS | RTT <30 d | Infections | Bleeding | Neurological Injury | Device malfunction/pump thrombosis | Pump-exchange |
|---|---|---|---|---|---|---|---|
| Marasco, 2020, “International experience using a durable, centrifugal- flow ventricular assist device for biventricular support” | – | – | 24/93 (26%) | 33/93 (36%) | 13/93 (14%) | Device malfunction 17/93 (18%); pump thrombosis 8/93 (9%) (all RVAD) | 7/93 (8%): 1 LVAD, 6 RVAD |
| McGiffin, 2020, “The results of a single-centre experience with HeartMate 3 in a biventricular configuration” | – | – | Driveline wound: 3/12 (25%) | All bleeding: 11/12 (92%); GIB 2/12 (2%) | 0/12 (0%) | Pump thrombosis 3/12 (25%), all RVAD | 1/12 (8%) |
| Maynes, 2020, “Right atrial versus right ventricular HeartWare HVAD position in patients on biventricular HeartWare HVAD support: a systematic review” | – | 12/19 (63.2%) for POB | – | GIB: total 15/56; RA 10/35; RV 5/21 | – | Pump thrombosis total 9/30 (30%): RA 3/10; RV 6/20 | – |
| Vierecke, 2019, “Results of primary biventricular support: an analysis of data from the EUROMACS registry” | – | – | Freedom from infection =61% (12 months) | Freedom from bleeding =82% (12 months) | Freedom from neurological events: 76% (12 months) | Freedom from device malfunction/thrombosis =95% (18 months) | – |
| Arabia, 2018, “Biventricular support with intracorporeal, continuous flow, centrifugal ventricular assist devices” | – | – | 3 months: 15 events (rate 62.1); 3–24 months: 14 events (rate 13.2) | 3 months: 16 events (rate 66.3); 3–24 months: 10; events per 100 patient-months (rate 9.5) | 3 months: 2 events (rate 8.3); 3–24 months: 3 events (rate 2.8) | Device malfunction 26%: 3 months: 9 events (rate 37.3); 3–24 months: 6 events (rate 5.7) | 4/38 (11%) |
| Shah, 2018, “Multicenter experience with the durable biventricular assist device” | ICU LOS 19 d (IQR 8–39); C: 12 d (IQR 7–23); D: 42 d (IQR 28–48); HLOS 43 d (IQR 25–59) | – | 27/46 (59%), undefined | GIB 14/46 (30%) | 10/46 (22%) | LVAD thrombosis 3/46 (7%); RVAD thrombosis 17/46 (37%) | 5/46 (11%) for PT (RVADs) |
| Lavee, 2018, “An international multicenter experience of biventricular support with HeartMate 3 ventricular assist systems” | – | – | 5/14 (36%), driveline wound infection 1/14 (7%) | GIB 1/14 (7%) | 1/14 (7%) | 2/14 pump thrombosis (14%) | 2/14 (14%) |
| Eulert-Grehn, 2018, “Two implantable continuous-flow ventricular assist devices in a biventricular configuration: technique and results” | – | – | – | – | – | 12 RVAD pump thromboses 12/39 (31%); 5 rTPA; 1 pump exchange; 4 deaths due to pump thrombosis | 1/39 (3%) |
| Tran, 2018, “Durable biventricular support using right atrial placement of the HeartWare HVAD” | ICU-LOS median 7 d; HLOS median 30 d | – | – | GIB 2/11 (18%) | 3/11 (27%) ICH | 4/11 (36%), thrombosis | 1/11 (9%) pump exchange |
| Levin, 2016, “Outcomes of contemporary mechanical circulatory support device configurations in patients with severe biventricular failure” | – | – | – | – | – | – | – |
| Maltais, 2016, “Surgical considerations and challenges for bilateral continuous flow durable device implantation” | – | – | – | 1/4 | 0/4 | 3/4 (75%) pump thrombosis | 2/4 |
| Shehab, 2016, “Long-term biventricular HeartWare ventricular assist device support - case series of right atrial and right ventricular implantation outcomes” | ICU-LOS median 14 d (IQR 8–36); HLOS median 53 d (IQR 33–70) | – | 7/13 (54%) total; DSWI 2/13 (15%); driveline infection 1/13 (8%) | 3/13 (23%) | 2/13 (15%) | 4/13 (31%) RVADs thrombosis: 1/7 RA; 3/6 RV | 0/13 (0%) |
| Krabatsch, 2011, “Biventricular circulatory support with two miniaturised implantable assist devices” | ICU-LOS mean 29 d (SD 30.8); HLOS mean 39 d | 6/17 (35%) for POB | 1/17 (6%), mediastinitis | 6/17 (35%) post-op bleeding; GIB 2/17 (12%) | – | – | – |
| Marasco, 2014, “Long-term right ventricular support with a centrifugal ventricular assist device placed in the right atrium” | – | 2/4 | 2/4 | 3/4 | – | 0/4 | 0/4 |
ICU-LOS, intensive care unit length of stay; HLOS, hospital length of stay; RTT, return to theatre; POB, post-operative bleeding; DSWI, deep sternal wound infection; GIB, gastro-intestinal bleeding; RA, right atrial; RV, right ventricular; ICH, intra-cerebral haemorrhage; LVAD, left ventricular assist device; RVAD, right ventricular assist device; PT, pump thrombosis.