Concomitant or late aortic valve intervention and its efficacy for aortic insufficiency associated with continuous-flow left ventricular assist device implantation

A study on the global patterns in the design and development of ventricular assist devices: a visualization approach

Introduction

Ventricular assist devices (VADs) are lifesavers for people with advanced heart failure. The design of these devices has undergone drastic changes over time with the latest designs being far more efficient, small, lightweight, and more user-friendly. This study aims to analyze publications using bibliometric analysis and see the progress and identify key themes, trends, and collaboration networks.

Method

Data relevant to this study were obtained from Scopus and Web of Science databases from 1990 to 2023. Data analysis was done using Biblioshiny which is an R-based software and is part of RStudio and Microsoft Excel to analyze collaboration between countries, authors, keyword analysis, trend topics, and evolution of various themes related to this study.

Results

A total of 489 published documents were analyzed, and these documents were from 158 different sources and 1,753 authors. The top contributing journals were Artificial Organs and Asaio Journal with 116 and 81 publications, respectively. The top contributing authors in terms of total documents were Nose Y (35) and Throckmorton A (30) and in terms of total citations were Pagani F (2005) and Mehra M (1952). Top countries include the USA, China, and Germany. The trend topics include miniaturization, machine learning, wireless, shear flow, and fiber-optic sensors.

Discussion

The latest technological advancements in VAD design are making them a more suitable choice for a large number of patients. This bibliometric work will aid in identifying the newest trends and developments in this field and highlight the areas where more research is needed. These data are crucial for driving innovation in this field and for improving the lives of patients who depend on VADs. Future studies can be conducted to explore the use of artificial intelligence and machine learning that can learn from data about patients and then adapt as per the requirements of the patients.

Current issues of destination therapy in Japan: to achieve 5-year or even longer survival

In April 2021, destination therapy (DT) was finally approved in Japan. Since DT does not aim at heart transplantation (HT), our goal is to have a patient safely remain on an implantable ventricular assist device (VAD) for the rest of his/her life. To achieve this goal, similarly to bridge-to-transplant (BTT) patients, the authors believe the following six aspects are even more crucial in DT patients: (1) to appropriately assess risks before implantation, (2) to carefully determine the ability to manage the device by multidisciplinary discussions, (3) to prevent complications by improving the quality of care, (4) to expand the number of facilities that can take care of DT patients by improving collaboration among the facilities, (5) to reduce the burden of caregivers by utilizing social resources, and (6) to establish a home palliative care system based on advance care planning. In addition, for elderly DT patients to live happy and long lives, it is essential to help them to find a purpose of life and to keep activities of daily living, such as employment, schooling, and participation in social activities, just like the general elderly population. Our goals are not only to do our best for the patients just in front of us, but also to establish a system to follow up our DT cohort, same as BTT one, by all-Japan manner. In the present review, we discuss the current state of DT in Japan and what we need to focus on to maintain or improve its long-term performance.