DuoCor 2 DOMINATE Study

Inclusion Criteria: * 1\. Age ≥ 18 years and ≤ 75 years * 2\. Patient is inotrope dependent, OR has a Cardiac Index (CI) \< 2.2 L/min/m2, while not on inotropes * 3\. Patient has left heart failure with at least one of the following criteria: * Left ventricular ejection fiction (LVEF) ≤ 30%; * Pulmonary capillary wedge pressure (PCWP) \> 15mmHg. * 4\. Patient has severe, irreversible biventricular heart failure and is eligible for biventricular mechanical circulatory support based on the ISHLT guideline. This includes at least two of the following hemodynamic and/or echocardiographic measurements: * Right ventricular ejection fraction (RVEF)≤ 30%; * Right ventricular stroke work index (RVSWI)≤ 0.25 mmHg\*L/m2; * Tricuspid annular plane systolic excursion (TAPSE)≤ 14 mm; * Right ventricular (RV) to left ventricular (LV) end-diastolic diameter ratio\> 0.72; * Central venous pressure (CVP)\> 15 mmHg; * CVP to PCWP ratio\> 0.63; * Tricuspid insufficiency grade 2-4; * Pulmonary artery pressure index (PAPi)\< 2; * 5\. Patient or its legal representative has signed the informed consent, has full understanding of procedures and the study, and is committed to following study requirements. Exclusion Criteria: * 1\. Known intolerance to anticoagulant or antiplatelet therapies. * 2\. Etiology of heart failure due to restrictive or constrictive physiology (e.g., hypertrophic cardiomyopathy, cardiac amyloidosis /senile or other infiltrative heart disease). * 3\. Coagulopathy defined by platelets \< 100k/µl or INR ≥ 1.5 not due to anticoagulant therapy. * 4\. Technical obstacles which pose an inordinately high surgical risk, in the judgment of the investigator. * 5\. Presence of temporary mechanical circulatory support such as Impella (all types) or IABP with a duration greater than 21 days. * 6\. Presence of ECMO with a duration greater than 10 days. * 7\. Patient is implanted with durable mechanical circulatory support (LVAD or RVAD) and has refused to switch to the study device. * 8\. Patient experienced cerebrovascular accident (CVA) within 3 months of eligibility evaluation. * 9\. Presence of any one of the following risk factors for indications of severe end organ dysfunction or failure: * Total bilirubin \> 3.0 mg/dL or cirrhosis confirmed by imaging or positive biopsy; * Glomerular filtration rate (GFR) \< 30 mL/min/1.73 m2 or renal replacement therapy dependence; * History of severe chronic obstructive pulmonary disease (COPD) defined by FEV1/FVC \< 0.7, or FEV1 \< 50% predicted. * Significant peripheral vascular disease (PVD) accompanied by rest pain or extremity ulceration; * 10\. Fixed pulmonary hypertension with a most recent PVR ≥ 8 Wood units. * 11\. Severe systemic light-chain amyloidosis. * 12\. Blood stream infection within seven days. Positive blood cultures reflective of contaminants (e.g., Staphylococcus epidermidis) will not be considered an exclusion. * 13\. Sepsis * 14\. History of confirmed, untreated abdominal aortic aneurysm (AAA) or thoracic aortic aneurysm (TAA) \> 5 cm in diameter. * 15\. Any condition other than HF that could limit survival to less than 24 months. * 16\. Positive pregnancy test if of childbearing potential. * 17\. Lactating mothers. * 18\. Participation in any other clinical investigation that is likely to confound study results or affect the study.