Therapeutic strategies using a ventricular assistive device for advanced heart failure in Japan

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  • Hada Tasuku
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Hifumi Toru
    Department of Emergency and Critical Care Medicine, St. Luke’s International Hospital
  • Fukushima Norihide
    Senri Kinran University

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Other Title
  • 本邦の重症心不全に対する補助人工心臓を用いた治療戦略

Abstract

<p>Refractory advanced heart failure is a challenging condition to treat, with a poor prognosis. Recently, the treatment of advanced heart failure has dramatically changed with progress in the field of heart transplantation and use of ventricular assist devices (VADs). In particular, the performance and outcome of VADs has improved, contributing to improved prognosis. In Japan, the National Health Insurance began to cover implantable VADs from May 2021 for patients who are not eligible for heart transplantation (destination therapy, DT). Therefore, the number of patients requiring DT is expanding, and it is necessary for intensivists to understand the treatment options so as to decide whether to switch to VAD therapy or not during the management of patients with advanced heart failure. In addition, it is important to consider consultation and transfer to a heart transplant or DT facility without missing the right timing. Furthermore, as the number of VAD patients is expected to increase in the future, it is necessary to learn the mechanism of functioning and emergency care of VADs.</p>

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