Ventricular assist devices in functionally univentricular hearts.

The enhanced survival rates of patients with functionally univentricular hearts can be credited to the ongoing development of surgical techniques and improved perioperative care. Hence, the population of single ventricle patients reaching the treating physician is increasing. Many of these patients go on to develop end-stage heart failure and may need a heart transplant. In this subgroup, the scarcity of donors calls for the potential necessity of employing mechanical circulatory support to facilitate heart transplantation. Ventricular assist devices are crucial in supporting the failing myocardium and improving systemic perfusion and tissue oxygenation. However, their implantation poses significant challenges due to the unique intrinsic anatomical and physiological characteristics of these patients. There is mounting evidence bolstering the use of ventricular assist devices in a subset of patients with functionally univentricular hearts. The purpose is to examine the evolution and current role of ventricular assist devices in this spectrum of patients, including its challenges and outcomes.