Mechanical circulatory support devices (MCSD) in Japan: current status and future directions

Abstract

The current status and future directions of mechanical circulatory support devices (MCSDs) in Japan are reviewed. Currently used clinical MCSDs, both domestic and imported systems and continuous flow devices that are coming into the clinical arena are emphasized. Clinical MCSDs include the extracorporeal pulsatile Toyobo and Zeon systems and the implantable Novacor and HeartMate I VE. A thorough review is presented of single-ventricle continuous flow MCSDs such as the Terumo DuraHeart and the SunMedical EVAHEART and the biventricular Miwatec/Baylor systems that are on the horizon. The future directions in management of end-stage cardiac patients with MCSDs are discussed, focusing on (1) device selection - pulsatile versus continuous flow devices; (2) single-ventricle support, biventricular support, or replacement; (3) bridge to transplantation, destination therapy, or bridge to recovery; and (4) government regulatory processes and the medical industry. We hope to promote the quality of life (QOL) of end-stage cardiac patients as well as the medical industry in Japan.

Post-transplant survival after lowering fixed pulmonary hypertension using left ventricular assist devices

“…Technical details as well as implantation procedures of the Micromed W DeBakey (MicroMed Technology Inc., Houston, USA) and Dura Heart W (Terumo Heart Inc., Michigan, USA) (continuous blood flow), as well as the Novacor W LVAD (World Heart Inc., Oakland, USA) (pulsatile blood flow) have previously been described [10][11][12].…”

Risk Factor Analysis of Long-Term Support With Left Ventricular Assist System

“…[4][5][6][7] In Japan, however, the special situation of heart transplantation and very limited device availability have made the indication and timing of LVAS implantation somewhat different from other countries. 8 Because of the extremely severe shortage of donor hearts, heart failure patients in Japan have to wait for heart transplantation for approximately 2 years on average with LVAS support. 8, 9 To make the situation worse, the only commercially available device in this country has been the Toyobo LVAS, which is a paracorporeal pneumatic-type LVAS that was initially designed for short-term support.…”

Initial Experience of Lower Limb Thermal Therapy for Patients with an Extracorporeal Left Ventricular Assist Device Awaiting Heart Transplantation

“…Sauna thermal therapy attenuates psychological stress (Kihara et al, 2004). Because of a donor shortage in Japan, patients must remain attached to an LVAD and stay in hospital for over 2 years while waiting for a heart transplant (Takatani et al, 2005). The decrease in plasma norepinephrine indicated that appendicular thermal therapy also might attenuate psychological, as well as physical stress.…”