Summary
Fewer children receive biventricular support than a decade ago, partly on the concern that outcomes lag behind what a left-sided device achieves alone. This study asked whether the timing of the right-sided device changes that picture.
The authors reviewed 223 pediatric patients in the ACTION registry who received biventricular support between April 2018 and December 2022. They split the group by timing: 186 children received both devices in a single operation, while the rest received the right-sided device within the following 60 days. Median age at implant was 5.5 years, and roughly a quarter had congenital heart disease.
Children in the single-operation group arrived at surgery in worse condition. More were on dialysis, and more had undergone previous sternotomies. They nonetheless had better survival through the first year.
The authors conclude that surgeons should have a low threshold for placing a right-sided device alongside the left when a patient shows signs of right heart failure.
This ACTION study was published online ahead of print on September 11, 2026 in the ASAIO Journal. Congratulations to the authors:
- Shannon Oliver
- Mark Bleiweis
- Matthew O’Connor
- Steve Kindel
- John C. Dykes
- Sabrina Law
- Lindsay May
- Aamir Jeewa
- Matthew Zinn
- Ryan Butts
- Bethany Wisotzkey
- Muhammad F. Shezad
- Jennifer Conway
- [on behalf of the Advanced Cardiac Therapies Improving Outcomes Network (ACTION)]
CITATION
Oliver, S., Bleiweis, M., Matthew O’Connor, M. et al. (2026). Does Earlier Right Ventricular Assist Device Implant Confer a Survival Advantage? ASAIO Journal. doi:10.1097/MAT.0000000000002838
