[Era of Major Transformation in Implantable Ventricular Assist Device Therapy]

Our hospital received certification as an implantable ventricular assist devices( iVAD) facility in 2018, and as of 2024, we continue to maintain this certification. We provide outpatient and inpatient care through a multidisciplinary heart team. Our team has implanted HeartMate 3 in three patients, and we also manage five patients with devices implanted at other facilities, for a total of eight iVAD patients under outpatient care. Fortunately, we have had no cases of readmissions due to driveline infections or cerebrovascular events. We recognize that, in addition to advancements in surgical techniques and device technology, close collaboration between patients and the heart team, as well as the involvement of wound, ostomy, and continence( WOC) nurses, are essential. Recently, this field has entered a major transformation. With improvements in heart failure treatment by the' fantastic four' and the advancements in Impella technology, the need for extracorporeal ventricular assist device (EVAD) has significantly declined, and cases achieving a bridge to recovery are not uncommon. Furthermore, as the number of stable iVAD patients grows, not only are destination therapy (DT) cases increasing, but elderly patients are effectively becoming DT cases, underscoring the importance of iVAD facilities in providing end-of-life case for these patients.