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To date at Osaka University, six types of LVADs have been used clinically: Jarvik2000, EVAHEART, DuraHeart, HeartMate II, HeartMate 3, and HVAD. In a total of 281 patients, the 5-year survival rate was a satisfactory 71%. Currently, the total number of LVADs has reached over 300, and the long-term survival rate at 2 years was approximately 95% for HeartMate 3 implants. In this report of long-term VAD therapy as bridge to transplantation (BTT), we have focused on the complications of the following: stroke, infection, aortic regurgitation, and right heart failure including tricuspid regurgitation. The characteristics of complications with long-term VAD support are analyzed to evaluate risk factors. In the neurological study, post-transplant MRI showed the presence of cerebral microbleeds very frequently. It was also found that underlying bacteremia significantly increased the risk of neurological complications in long-term VAD patients. Although the number of heart transplants is limited, our experience with long-term VAD as BTT may be helpful in further refining this treatment strategy. Also, the analysis of these patients from the view of  complication at long-term support may give important information to the ongoing destination therapy (DT).

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Role of Implantable Ventricular Assist Device in End-Stage Heart Failure: Bridge to Transplantation and Destination Therapy

  • 章节

  • 发表日期：

    2025年

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  • Daisuke Yoshioka,
  • Shigeru Miyagawa

摘要

To date at Osaka University, six types of LVADs have been used clinically: Jarvik2000, EVAHEART, DuraHeart, HeartMate II, HeartMate 3, and HVAD. In a total of 281 patients, the 5-year survival rate was a satisfactory 71%. Currently, the total number of LVADs has reached over 300, and the long-term survival rate at 2 years was approximately 95% for HeartMate 3 implants. In this report of long-term VAD therapy as bridge to transplantation (BTT), we have focused on the complications of the following: stroke, infection, aortic regurgitation, and right heart failure including tricuspid regurgitation. The characteristics of complications with long-term VAD support are analyzed to evaluate risk factors. In the neurological study, post-transplant MRI showed the presence of cerebral microbleeds very frequently. It was also found that underlying bacteremia significantly increased the risk of neurological complications in long-term VAD patients. Although the number of heart transplants is limited, our experience with long-term VAD as BTT may be helpful in further refining this treatment strategy. Also, the analysis of these patients from the view of  complication at long-term support may give important information to the ongoing destination therapy (DT).