5. Conclusion
From 2009 to 2015, BiVAD utilization decreased, and the associated costs increased, while LVAD utilization increased, and the related cost and mortality decreased. While the mortality rate among BiVAD patients did not change, the patient population had an increasing burden of comorbidities during this time. Compared to patients with external BiVADs, patients with internal BiVADs had longer LOS and higher costs associated with their hospitalizations, but were also more likely to survive. More studies regarding the optimal BiVAD configurations are needed to determine appropriate patient selection and perioperative care to improve outcomes and cost-efficiency.