An 18-year-old boy with dilated cardiomyopathy developed a relatively rapid deterioration and went into severe congestive heart failure. After short-while use of percutaneous cardiopulmonary support system (PCPS) and IABP, LVAS was indicated because of persisting low cardiac output syndrome and deterioration of organ functions. An LVAS (TOYOBO) was implanted on June 26, 1992 in a fashion of left atrium to ascending aorta bypass. Satisfactory circulatory support (flow rates of 4-5 L/min) was achieved resulting in complete recovery of the organ functions. After two months of LVAS support, the patient was transported to U.S.A.. The LVAS system was working well without any problems during 17 hrs flight under low atmospheric pressure (0.8 atm) in the plane. The patient successfully underwent heart transplantation (HTx) at Texas Heart Institute after 119 days support of LVAS. The patient is doing well enjoying active life after HTx. This is the first case of successful bridge use of extracorporeal LVAS to HTx in Japan.