Destination therapy: the new gold standard treatment for heart failure patients with left ventricular assist devices
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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.
- Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345:1435–43. CrossRef
- Slaughter MS, Rogers JG, Milano CA, Russell SD, Conte JV, Feldman D, et al. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009;361:2241–51. CrossRef
- Yamane T, Kyo S, Matsuda H, et al. Japanese guidance for ventricular assist devices/total artificial hearts. Artif Organs. 2010;34(9):699–702. CrossRef
- Omoto R, Kyo S, Nishimura M, Matsuda H, Matsumiya G, Kitamura S, et al. Japanese multicenter clinical evaluation of the HeartMate vented electric left ventricular assist system. J Artif Organs. 2005;8(1):34–40. CrossRef
- Kyo S, Minami T, Nushimira T, Ono M. New era for therapeutic strategy for heart failure: destination therapy by left ventricular assist device. J Cardiol. 2012;59(2):101–9. CrossRef
- Kurihara C, Ono M, Nishimura T, Saito A, Taketani T, Hisagi M, et al. Use of DuraHeart support for more than 1 year as the first successful bridge to heart transplantation in Japan. J Artif Organs. 2011;14(1):67–9. CrossRef
- Yoshioka D, Sakaguchi T, Saito S, Miyagawa S, Nishi H, Yoshikawa Y, et al. Initial experience of conversion of Toyobo paracorporeal left ventricular assist device to DuraHeart left ventricular assist device. Circ J. 2012;76(2):372–6. CrossRef
- Stehlik J, Edwards LB, Kucheryavaya AY, Benden C, Christie JD, Dobbels F, et al. The Registry of the International Society for Heart and Lung Transplantation: Twenty- eighth Adult Heart Transplant Report—2011. J Heart Lung Transplant. 2011.
- Stewart GC, Givertz MM. Mechanical circulatory support for advanced heart failure—patients and technology in evolution. Circulation. 2012;125(10):1304–15. CrossRef
- Ventura PA, Alharethi R, Budge D, Reid BB, Horne BD, Mason NO, et al. Differential impact on post-transplant outcomes between pulsatile- and continuous-flow left ventricular assist devices. Clin Transplant. 2011;25(4):E390–5. CrossRef
- Nativi JN, Drakos SG, Kucheryavaya AY, Edwards LB, Selzman CH, Taylor DO, et al. Changing outcomes in patients bridged to heart transplantation with continuous- versus pulsatile-flow ventricular assist devices: an analysis of the registry of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2011;30(8):854–61.
- Garbade J, Bittner HB, Barten MJ, Mohr FW, et al. Current trends in implantable left ventricular assist devices. Cardiol Res Pract. 2011;2011:290561.
- Stevenson LW, Hunt SA. A bridge far enough? Circulation 2012. [Epub ahead of print].
- Milano CA, Simeone AA. Mechanical circulatory support: devices, outcomes, and complications. Heart Fail Rev. 2012.
- Park SJ, Tector A, Piccioni W, Raines E, Gelijns A, Moskowitz A, et al. Left ventricular assist devices as destination therapy: a new look at survival. J Thorac Cardiovasc Surg. 2005;129:9–17. CrossRef
- Long JW, Kfoury AG, Slaughter MS, Silver M, Milano C, Rogers J, et al. Long-term destination therapy with the HeartMate XVE left ventricular assist device: improved outcomes since the REMATCH study. Congest Heart Fail. 2005;11(3):133–8. CrossRef
- Stewart GC, Stevenson LW. Keeping left ventricular assist device acceleration on track. Circulation. 2011;123:1559–68. CrossRef
- Kirklin JK, Naftel DC, Kormos RL, Stevenson LW, Pagani FD, Miller MA, et al. Third INTERMACS Annual Report—the evolution of destination therapy in the United States. J Heart Lung Transplant. 2011;30(2):115–23. CrossRef
- Egawa H, Tanabe K, Fukushima N, Date H, Sugitani A, Haga H. Current status of organ transplantation in Japan. Am J Transplant. 2012;12:523–30. CrossRef
- Ono M. Ventricular assist device and heart transplantation in Japan. Masui. 2009;58(3):327–36.
- Jeevanandam V. Are we ready to implant left ventricular assist devices in “Less Sick” patients? Semin Thorac Cardiovasc Surg. 2012;24(1):8–10. CrossRef
- Kirklin JK, Naftel DC, Kormos RL, Stevenson LW, Pagani FD, Miller MA, Baldwin JT, Young JB. The Fourth INTERMACS Annual Report: 4,000 implants and counting. J Heart Lung Transplant. 2012;31(2):117–26. CrossRef
- Destination therapy: the new gold standard treatment for heart failure patients with left ventricular assist devices
General Thoracic and Cardiovascular Surgery
Volume 61, Issue 3 , pp 111-117
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Left ventricular assist device
- Destination therapy
- Heart transplantation
- Heart failure
- Industry Sectors
- Author Affiliations
- 1. Department of Therapeutic Strategy for Heart Failure, University of Tokyo Hospital, Tokyo, Japan
- 2. Department of Cardiothoracic Surgery, University of Tokyo Hospital, Tokyo, Japan