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[Ventricular Assist Device].

Minoru Ono1

  • 1Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
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Summary
This summary is machine-generated.

Continuous-flow ventricular assist devices (CFVADs) have significantly improved outcomes for end-stage heart failure patients in Japan. With high survival rates and expanding indications, CFVADs offer a promising long-term support solution.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Device Technology
  • Heart Failure Management

Background:

  • The first paracorporeal ventricular assist device (VAD) was implanted in Japan in 1980, with over 2,000 VADs used since.
  • Continuous-flow VADs (CFVADs), developed in the 1990s, have enhanced the safety and efficacy of long-term cardiac support.

Purpose of the Study:

  • To review the development and adoption of CFVADs in Japan.
  • To highlight the clinical outcomes and future directions of VAD therapy in Japan.

Main Methods:

  • Analysis of data from the Japan Mechanical Circulatory Support (J-MACS) registry.
  • Review of approved VAD devices and their indications in Japan.
  • Examination of survival statistics and treatment trends.

Main Results:

  • Several CFVADs, including EVAHEART and DuraHeart, received insurance approval starting in 2011, followed by HeartMate II and Jarvik 2000.
  • As of 2016, over 500 CFVADs were implanted, with 1- and 2-year survival rates of 93% and 90%, respectively.
  • The Berlin Heart EXCOR Pediatric was approved in 2015, expanding treatment for neonates and infants. Destination therapy trials are set to begin.

Conclusions:

  • CFVADs have demonstrated superior survival rates compared to INTERMACS data, becoming a vital treatment for end-stage heart failure in Japan.
  • The increasing waiting times for heart transplantation necessitate longer support durations with fewer complications, a role CFVADs are increasingly filling.
  • VAD therapy in Japan is poised for continued growth and improvement, with expanding applications and ongoing clinical trials.