Although biventricular heart failure has been successfully managed with dual continuous-flow ventricular assist devices, the long-term use of 2 mechanically dissimilar pumps has traditionally been discouraged. We present the case of a 52-year-old man whose treatment with a HeartMate II left ventricular assist device was complicated by right ventricular failure, necessitating the implantation of a long-term right ventricular assist device. A HeartWare left ventricular assist device was placed along the right ventricular base to avoid interference with the HeartMate II housing. The patient was discharged from the hospital after routine postoperative care and dual-device training. This case shows that, despite logistical complexities, nonidentical continuous-flow device pairings can successfully provide long-term biventricular support.
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