[Current Status of Implantable Ventricular Assist Device]

Implantable ventricular assist device( iVAD) was initially approved in Japan as bridge-to-transplantation( BTT) indication in 2011. Since then, 1,458 iVAD implants were performed as BTT, and this number per year is rapidly increasing, especially after the approval of iVAD implant as destination therapy (DT) indication in 2021. Some of DT patients will be eventually registered for heart transplantation, once their exclusion criteria are cleared, thus extending waiting time of BTT patients in the setting of serious donor shortage in Japan. Therefore, to improve the outcome of iVAD patients, both BTT and DT, it is imperative to manage device-associated complications that can occur during prolonged longterm iVAD support. In the present review, we summarize the recent updates on the iVAD treatment in Japan, in terms of device-associated complications, especially driveline infection, right ventricular failure and aortic regurgitation.