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Published in: Journal of Artificial Organs 3/2014

01-09-2014 | Review

Current status of extracorporeal ventricular assist devices in Japan

Author: Takashi Nishimura

Published in: Journal of Artificial Organs | Issue 3/2014

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Abstract

Extracorporeal VADs are less expensive, their prices reimbursable by the health insurance being about one-sixth of those of implantable VADs in Japan. However, a disadvantage is that, in Japan, their use is restricted to hospitals, necessitating prolonged hospitalization, reducing the patients’ quality of life. According to the Japanese registry for Mechanically Assisted Circulatory Support, the survival rate does not differ significantly between patients with extracorporeal and implantable VADs. As in Europe and North America, extracorporeal VADs in Japan are commonly used as Bridge to Decision or Bridge to Recovery. Extracorporeal VADs are switched to implantable VADs as a Bridge-to-Bridge strategy after stabilization or when cardiac function recovery fails. They are also used as right ventricular assist devices (RVADs) in patients with right heart failure. A special characteristic of extracorporeal VADs in Japan is their frequent use as a Bridge to Candidacy. In Japan, indications for implantable VADs are restricted to patients registered for heart transplantation. Therefore, in patients who cannot be registered for transplantation because of transient renal dysfunction, etc., due to heart failure, extracorporeal VADs are used first, and then replaced by implantable VADs after transplant registry is done. Here, we describe the current status of extracorporeal VADs in Japan, focusing on the environmental backgrounds, along with a review of the relevant literature.
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Metadata
Title
Current status of extracorporeal ventricular assist devices in Japan
Author
Takashi Nishimura
Publication date
01-09-2014
Publisher
Springer Japan
Published in
Journal of Artificial Organs / Issue 3/2014
Print ISSN: 1434-7229
Electronic ISSN: 1619-0904
DOI
https://doi.org/10.1007/s10047-014-0779-8

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