Clinical differences between destination therapy and bridge-to-transplant left ventricular assist device implantation: a 17-year single-center experience in Japan.

The use of left ventricular assist device (LVAD) implantation for destination therapy (DT) has been recently increased worldwide. In 2021, DT was also approved in Japan. Here, we report a single-institution experience of LVAD implantation for DT. This retrospective observational study was conducted at Osaka University Medical Hospital in Japan. Forty patients who underwent LVAD implantation for DT were included. The primary endpoint was on-device survival, and the secondary endpoint was the incidence of LVAD-related complications at five years. The on-device survival rates were 82.3%, 73.3%, and 49.8% at 1, 3, and 5 years, respectively. Most patients (90.6%) experienced rehospitalization during the follow-up period and the most common cause was LVAD-related infection. One-quarter of the patients (10 cases) required LVAD pump exchange, also most commonly due to LVAD-related infection. Comparative analysis with 213 patients who underwent LVAD implantation for bridge to transplant (BTT) revealed no significant change in the primary and secondary outcomes. Our results demonstrate favorable clinical outcomes for LVAD implantation for DT in this Japanese cohort.