The Destination Therapy Evaluation for Failing Fontan Study

Inclusion Criteria: * Able to sign Informed Consent and Release of Medical Information forms * Age greater than or equal to 18 years * Appropriate surgical candidate for the HeartMate II LVAD * Willing to consider treatment with the HeartMate II LVAD * BSA greater than or equal to 1.2 * Female patients must be using adequate contraceptive methods or be unable to become pregnant (2 years post-menopausal or surgically sterilized) * Patient has Stage D heart failure for, at least, 60 days despite optimal medical management for at least the last 60 days * Functional limitation due to heart failure as defined by at least ONE of the following: 1. A history of a progressive downhill course manifested by a restricted quality of life, or increasing hospital admissions, or increasing medication requirements 2. Presence of protein losing enteropathy * Ineligible for cardiac transplantation at Sacred Heart Medical Center and at least one other UNOS approved heart transplant center, in the judgment of that center's multidisciplinary transplant team * Ability to read, understand and implement the instructions for use for the HeartMate II LVAD Exclusion Criteria: * Technical obstacles that pose an inordinately high surgical risk, in the judgment of the investigator * Uncorrectable acquired coagulopathy * Primary coagulopathy or platelet disorder, including thrombocytopenia with absolute platelet count \< 80k or active state of disseminated intravascular coagulation * Contraindication to the administration of heparin, warfarin or anti-platelet agents * Severe intrinsic pulmonary disease in the judgment of the investigator * On mechanical ventilatory support and unable to be weaned * Patient is under consideration for reparative cardiac surgery (likely to result in clinical resolution of the heart failure in the judgment of the investigator) * Prior implantation of an assist device * Mechanical prosthetic aortic or mitral valve that will not be converted to a bio-prosthesis at time of VAD implantation * Moderate or severe (\>1+) aortic insufficiency as determined by echocardiogram that is not amenable to surgical repair or replacement * Evidence of severe intrinsic hepatic disease as defined as biopsy proven liver cirrhosis with a likelihood of less than two years survival; or liver enzyme values (AST, ALT or total bilirubin) that are \> 3 times the upper limit of normal within 30 days prior to surgery, except if the result of acute heart failure decompensation as determined by the investigator * Creatinine of \> 3.5mg/dl or any form of dialysis within 24 hours prior to surgery * Stroke within 90 days prior to surgery, or history of cerebral vascular disease with significant (\> 80%) extra cranial or intra cranial stenosis documented by carotid doppler study or angiography, without evidence of collateral flow documented by transcranial doppler study * Alzheimer's disease and/or impaired cognitive function, or any other form of irreversible dementia (or both) that is confirmed by a neurological exam * Patient has evidence of an untreated abdominal aortic aneurysm ≥ 5 cm as measured by abdominal ultrasound * Suspected or active systemic infection within 48 hours prior to surgery * Significant peripheral vascular disease as defined by rest pain or ulceration * Patient in whom abdominal surgery is planned * Positive serum pregnancy test, for women of childbearing potential * Recent history of psychiatric disease or psycho-social maladaptive behaviors (including drug or alcohol abuse) that are likely to impair compliance with the study protocol, in the judgment of the investigator * Therapy with an investigational intervention at the time of screening, or plan to enroll patient in additional investigational intervention study during participation in this trial * Patient has a condition, other than heart failure, which would limit survival to less than 2 years * Patient is eligible for cardiac transplantation