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Objective: We report non transplant surgical procedure (preserving autologous heart operation) for the patients with dilated cardiomyopathy( DCM), clinical outcomes, and the factor of predict prognosis., Patient and Method: Since May 2000, 258 patients received surgical procedure for 11 years., Surgical Procedures: We performed mitral surgery (plasty or replacement) for the patients with more than mild mitral regurgitation (MR). We performed papirally muscule plication since 2005, and we performed 2nd chordal cutting since 2008, for the patients with MR due to mitral tethering. The surgical left ventricular reconstruction( SVR) was performed for the patients with dilated left ventricular. We use spackle tracking echocardiography to decide the type of SVR since 2008., Result: Hospital death was 18.2%, and late cardiac death was 27.5%.Almost the cause of death was congestive heart failure and ventricular arrhythmia. Five years survival was 58%, 10 years survival was 39%. Preoperative condition, emergent operation, inotropic support, intra aortic balloon pumping(IABP),affect the prognosis. But left ventricular size did not affect it., Conclusion: Surgical treatment for the patient with DCM should be performed with stable preoperative condition.

Cardiac surgery has been developed dramatically during these 50 years since Gross and Lellihei pioneered repair of intracardiac anomalies using cardiopulmonary bypass in mid 1950's. In late 1960's and early 1970's, the technique of deep hypothermia and circulatory arrest (DHCA) has been developed in Japan and Sir Brian Barratt-Boyes in New Zealand used Kyoto technique (DHCA) to repair many infants and small children with complex congenital heart diseases (CHD). The introduction of DHCA was an important development in the history of the treatment of CHD, allowing the approach of previously unrepairable lesions. Open heart surgery in neonates has been adopted worldwide since Castaneda in Boston performed neonatal arterial switch in mid 1980's. Since then, most of our efforts have been led to repair most of the CHD primarily in neonate and small infants. Mortality of open heart surgery in neonates has dropped significantly during recent 10 years and now, more than 95% of the children with CHD survive in Japan. Surgical strategies and results in each CHD were summarized.

The development of closed chest cardiopulmonary bypass systems has opened the door for totally endoscopic cardiac surgery. We used the robotic surgical system ZEUS for closure of the atrial septal defect (ASD) in three patients. Under one-lung ventilation, Port-Access cardiopulmonary bypass system of the drainage from the right internal jugular vein and the the right femoral vein and the return to the right femoral artery was started after port placement at the forth intercostal space of the right thoracic wall. ASD direct closure was achieved by using robotic surgical system ZEUS under cardiac arrest. The three patients were discharged in 7 days after the operation uneventfully. The robotic surgical system ZEUS can make cardiac surgeries less invasive than ever.