HeartMate 6 in a Total Artificial Heart Configuration After Total Cardiectomy for Cardiac Sarcoma.

We present the case of a 34-year-old patient with an unresectable cardiac sarcoma who underwent a total cardiectomy followed by implantation of 2 HeartMate 3 devices in a total artificial heart configuration. Surgical treatment of cardiac sarcomas ranges from palliative debulking to heart transplantation. In contrast to conventional total artificial heart placement, complete removal of both atrioventricular connections was mandated by the underlying pathologic process. Hemodynamic performance of 2 continuous flow pumps in the absence of native atria and the heart reservoir function depends on balancing preload, afterload, and individual pump rotations. The unreliability of conventional monitoring parameters in this clinical scenario makes hemodynamic management challenging.