Related Experiment Video
Updated: Jun 12, 2025
07:27
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
24.6K
[Current State of Right Heart Failure after Implantable Ventricular Assist Device]
Naoki Eguchi1, Akira Sezai, Masashi Tanaka
1Department of Cardiovascular Surgery, Nihon University, Tokyo, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|June 10, 2025
Summary
Survival rates for ventricular assist devices (VADs) in Japan are stable, but major complications like neurological dysfunction, hemorrhage, and infection persist. Right heart failure is improved post-implantable left VAD (iLVAD) but requires careful management.
Area of Science:
- Cardiovascular Surgery
- Mechanical Circulatory Support
- Heart Failure Management
Context:
- The Japanese registry for Mechanically Assisted Circulatory Support (J-MACS) provides data on ventricular assist device (VAD) outcomes in Japan.
- Survival rates for VADs have stabilized, but significant complications remain a challenge.
- Right heart failure is a concern following implantable left VAD (iLVAD) implantation, particularly in Japan's context of long heart transplant waiting times.
Purpose:
- To analyze the outcomes of VADs in Japan, focusing on survival rates and complication incidence.
- To discuss the management of right heart failure after iLVAD, including the role of temporary right VAD (RVAD) and biventricular assist devices (BiVAD).
- To highlight the challenges in RVAD management due to long waiting periods for heart transplantation and present a case study.
Summary:
- VAD survival rates in Japan show stability at 93% (1 year), 90% (2 years), and 81% (4 years).
- Major complications (neurological dysfunction, hemorrhage, infection) persist despite decreased incidence.
- Right heart failure, though improved by iLVAD, requires management, with RVAD and BiVAD use influenced by transplant waiting times.
Impact:
- Findings underscore the need for improved strategies to mitigate VAD complications.
- The study highlights the unique challenges of RVAD and BiVAD management in Japan.
- A case report illustrates the potential for long-term BiVAD support and its implications for heart transplantation.
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