General Thoracic and Cardiovascular Surgery

, Volume 61, Issue 3, pp 111–117

Destination therapy: the new gold standard treatment for heart failure patients with left ventricular assist devices

  • Michael Yamakawa
  • Shunei Kyo
  • Sean Yamakawa
  • Minoru Ono
  • Koichiro Kinugawa
  • Takashi Nishimura
Current Topics Review Article

DOI: 10.1007/s11748-012-0181-5

Cite this article as:
Yamakawa, M., Kyo, S., Yamakawa, S. et al. Gen Thorac Cardiovasc Surg (2013) 61: 111. doi:10.1007/s11748-012-0181-5
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Abstract

Heart failure continues to be a growing health problem, eluding large-scale improvement and treatment. Cardiac transplantation has been the gold standard treatment with high post-transplant survival rates and relatively good quality of life. However, there has been an extreme shortage of organ donations, limiting transplants to only a very small portion of patients with the condition. This led to a growing interest in alternative options for the increasing population of patients who are waitlisted or ineligible for transplantation. In recent years, ventricular assist device (VAD) technologies have advanced from pulsatile blood pumps to continuous-flow pumps that have demonstrated unprecedented post-implantation survival rates. The HeartMate II, the only commercially available, continuous flow left ventricular assist device (LVAD) in the United States and Europe, has been implanted in over 10,000 patients worldwide, setting a benchmark for biomedical modalities of advanced heart failure treatment. Thanks to the successes of contemporary LVADs, patients are able to enjoy a better lifestyle, with a significantly prolonged life span and the ability to regularly partake in physical activities. In this new biomedical generation, the usage of LVADs has begun to expand towards the treatment for a wider range of heart conditions, including earlier stages of heart failure. In fact, LVAD implantations have surpassed the number of transplants taken place annually. An increasing number of patients are considering the permanent, circulatory support with an LVAD, namely destination therapy, as a promising option for treating heart failure.

Keywords

Left ventricular assist deviceDestination therapyHeart transplantationBridge-to-transplantationHeart failure

Copyright information

© The Japanese Association for Thoracic Surgery 2012

Authors and Affiliations

  • Michael Yamakawa
    • 1
  • Shunei Kyo
    • 1
  • Sean Yamakawa
    • 1
  • Minoru Ono
    • 2
  • Koichiro Kinugawa
    • 1
  • Takashi Nishimura
    • 1
  1. 1.Department of Therapeutic Strategy for Heart FailureUniversity of Tokyo HospitalTokyoJapan
  2. 2.Department of Cardiothoracic SurgeryUniversity of Tokyo HospitalTokyoJapan