The failing Fontan circulation can be challenging to support with ventricular assist devices, mostly because of the variety of causes of failure, some of which cannot be addressed by VAD therapy alone. A new ventricular assist device, the HeartMate 3 (Abbott, Chicago, IL), was recently approved for use in adults in the United States and is now widely available, with excellent survival results in two-ventricle patients. This case report describes the first successful implantation of the HeartMate 3 in a 22-year-old man with a failing Fontan circulation and the possible benefits this device may have in supporting this ever-growing population of young adults with single ventricles.
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