Division of Adult Cardiac Surgery
Overview
Overview and features of the Division
In 2017, the Division of Adult Cardiac Surgery performed more surgeries than ever before. Along with the Division of Vascular Surgery and the Division of Pediatric Cardiovascular Surgery, more than 1,000 cardiotomy surgeries were performed. At our division, we actively treat refractory and rare diseases using our expertise, while we improve existing therapies in terms of safety and outcome. In particular, we use new therapies such as catheterization for the treatment of aortic valve disease (transcatheter aortic valve implantation [TAVI]), minimally invasive cardiac surgery (MICS), and robotic surgery (using the da Vinci system) decrease the burden on patients.
We perform coronary artery bypass off pump, without using a heart-lung machine, as much as possible. Whenever possible, we use arterial grafts, which result in high long-term patency rates. Arterial grafts account for 95% of cases. We aim to perform surgeries with a high level of patient satisfaction. If indicated, we perform minimally invasive coronary surgery/coronary artery bypass grafting (MICS-CABG), which is performed with only a small incision by collecting an internal mammary artery using the da Vinci robot.
For valvular disease, we have performed more than 300 cases of TAVI. Because TAVI does not require an incision, patients over 90 years of age have been treated using this method. Our facility is the only one in Japan that participated in the global registry of the valve-in-valve procedure, promoting TAVI worldwide. Moreover, MICS via right minithoracotomy and robotic surgery are representative minimally invasive surgeries in the field of cardiac surgery. We have performed more than 250 of these procedures in total. The advantages of these surgeries not only result directly from lower invasiveness, such as less pain and bleeding, but also include social advantages such as the ability to drive or go back to work sooner after surgery.
We have performed approximately 100 robotic surgeries. The newest device for robotic surgery, da Vinci Xi, has recently been introduced in our center. It offers a very good visual field, sensitive robotic arms, and considerably improved operability compared with the previous version. Its capacity is fully utilized in valvuloplasty for mitral insufficiency; the long-term outcome is excellent and there are fewer complications associated with warfarin. Therefore, valvuloplasty using da Vinci Xi is actively performed at our center. For valvular diseases accompanied by atrial fibrillation, we perform maze surgery using the cutting-edge cryoIce device, which was introduced in 2017. We have performed more than 100 procedures with favorable results.
Surgical treatment of heart failure is also an important mission of this center. In 2017, we treated 70 patients using artificial hearts. As a result, NCVC became the only institution in Japan, and the ninth worldwide, certified as a Center of Excellence. This year, our division introduced a minimally invasive artificial heart (Impella). We expect that this device will be useful.
In addition, we treat heart neoplasms, constrictive pericarditis, and emergency diseases. Our division is prepared to accept patients requiring emergency treatment 24 hours a day in collaboration with intensive care units and coronary care units. Although we actively perform surgery in the most severe cases, our goal is not just prolongation of life. We also consider improvement of patients' quality of life to be an important goal.
The mission of the Division of Adult Cardiac Surgery at NCVC is to provide the best treatment to all patients equally and to offer surgical treatment at any time when needed. The staff in our division are ready 24 hours and have a rock-solid cooperative structure ("heart team") with the internal medicine departments, anesthesiology department, operating rooms, and other related departments. A total of 13 members, including residents and graduate students from Tohoku University, Keio University, and Kumamoto University, make up our vibrant heart team that actively treats patients and conducts research.
Certifications
- Japan Surgical Society
- Japanese Society for Cardiovascular Surgery
- Japanese Association for Thoracic Surgery
- Japanese Society for Vascular Surgery
- Japanese Circulation Society
- Respiratory Surgeon
last updated : 2021/10/05