Left ventricular reconstruction for severely dilated heart.

Surgical interventions for ischemic or non-ischemic heart failure refractory to medical treatment include the implantation of an artificial heart, tissue engineering medicine, and myocardial substitute, in addition to conventional coronary revascularization for ischemic heart disease (IHD) and undersized mitral annuloplasty (UMAP) for functional mitral regurgitation (FMR) causing myocardial damage. Remarkable progresses have been made in these surgical methods, but they have not necessarily reached a satisfactory level for clinical application. Cardiac transplantation, a final option of treatment for refractory heart failure, has not been a standard procedure especially in Japan, mainly due to the shortage of donors, despite a number of efforts to make it a standard procedure made so far by medical personnel and other parties concerned. Ischemic cardiomyopathy (ICM) or non-ICM is a disease of myocardium per se; thus cardiac transplantation or implantation of an artificial heart would be a final option of surgical methods for severely dilated heart failure refractory to treatment. However, surgical methods to restore native heart functions are often effective for those with an extremely low cardiac function. Although a longterm prognosis of these procedures is undetermined, they are considered to be an important option of treatment, at least as an alternative or biologic bridge to transplantation or artificial heart implantation. Left Ventricular Reconstruction for Severely Dilated Heart