Surgical Treatment for Severe Heart Failure: Recent Progress in Treatment Strategy and its Present Status in Japan

Chronic intractable heart failure that is unresponsive to maximum medical therapy canhave a wide variety of causes; these include advanced valvular diseases and severemyocardial ischemia, ischemic cardiomyopathy (ICM) in heart failure following extensivemyocardial infarction, chronic heart failure due to dilated cardiomyopathy (DCM) in whichthe myocardium itself is progressively damaged or the acute aggravation of the latter.Heart transplantation has long been considered the only useful treatment for patients withheart failure due to ICM- and DCM-induced severe left ventricular hypofunction. However,because of the extremely limited number of heart transplant donors, other surgicaltreatments have also been attempted. In this communication, we provide an overview of thecurrent situation with regard to left ventriculoplasty and heart transplantations, as wellas of the treatment of severe heart failure using ventricular assist devices, which haverecently shown remarkable progress.