[Treatment of end-stage heart failure by implantable ventricular assist devices].

The strategy for severe heart failure treatment has changed dramatically since 2011 by the initiation of clinical use of implantable continuous flow ventricular assist devices( LVADs) in Japan. The continuous flow LVADs include DeBakey ventricular assist device (VAD), HeartMate II, HeartWare, Dura-Heart, and EVAHEART, although EVAHEART alone is clinically available in Japan currently. Hear-Mate II is the most popular LVAD with more than 10,000 worldwide implants, while its clinical result is superior to implantable pulsatile LVADs. Crucial complications with implantable LVADs include infection, aortic valve insufficiency, thromboembolism, bleeding, and right heart failure during circulatory support. Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) has started in the United States, while Japanese Registry for Mechanically Assisted Circulatory Support(JMACS) initiated in Japan in 2010. These registries are essential for clinical evaluation of implantable LVADs as well as research and development in this field. The circulatory support with implantable LVADs is expected to be further contribution for the treatment of for end-stage heart failure patients.