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In Japan, there are unique opportunities to investigate the outcome of acute and chronic MCS and a national registry for percutaneous and implantable left ventricular assist device (LVAD) including Impella pumps has been established. A Peripheral extracorporeal membrane oxygenation (ECMO) for acute MCS has been used in more than 7000 patients annually and Impella usage in more than 4000 patients over the past 4\u2009years was noted. Recently, a novel centrifugal pump with hydrodynamically levitated impeller was developed and approved for mid\u2010term extracorporeal circulatory support. In terms of chronic MCS more than 1200 continuous flow LVADs have been implanted during the past decade, and 2\u2010year survival rate after primary LVAD implantation is 91%. Because of donor organ shortage, more than 70% of heart transplant recipients required LVAD support for more than 3\u2009years and prevention and treatment of complications during long\u2010term LVAD support have become important. Five important topics including hemocompatibility\u2010related complications, LVAD infections, aortic valve insufficiency, right ventricular failure and cardiac recovery during LVAD support are discussed in this review for improving clinical outcomes. Findings from Japan will continue to provide useful information regarding MCS for the Asia\u2010Pacific region and beyond.<\/jats:p>","DOI":"10.1111\/aor.14536","type":"journal-article","created":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T12:50:11Z","timestamp":1683204611000},"page":"914-924","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Mechanical circulatory support for adults in Japan: A 10\u2010year perspective"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4517-4939","authenticated-orcid":false,"given":"Koichi","family":"Toda","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery Osaka University Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M.","family":"Bernhardt","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery University Heart 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