[Cardiomyopathy and myocarditis; surgical treatment including ventricular assist device and heart transplantation].

Medical treatment is the 1st choice for cardiomyopathy and myocarditis. Adequate medical treatment is not sometimes insufficient, and advanced heart failure condition may be brought about in fulminant myocarditis, dilated cardiomyopathy (DCM) and dilated phase of hypertrophic cardiomyopathy (dHCM). Although left ventricular restoration operation is conducted in selected cases of these cardiomyopathies, hospital mortality is high partly due to lack of uniform indication of this type of surgery. Mitral valve plasty including (restrictive) annuloplasty and submitral apparatus procedures or mitral valve replacement with chordal preservation is performed in mitral valve regurgitation accompanying mitral tethering. In an end-stage heart failure, implantation of ventricular assist device (VAD) or heart transplantation may be indicated. Two kinds of small Japan-made implantable devices have been approved for clinical use. EVAHEART is a 2nd-generation centrifugal VAD which is equipped with unique cool-seal system. DuraHeart is a 3rd-generation centrifugal VAD which has magnetical levitation system. The Revised Organ Transplantation Law has become effective July 2010. The number of heart transplantation is increasing since then. Ninety-six heart transplantation were performed as of the end of February 2011, and 10-year survival rate is 95%, which is far superior to international data.