Centers & Services

Cardiovascular Surgery Department

What is the Cardiovascular Surgery Department?

The Department of Cardiovascular Surgery and the Department of Cardiovascular Medicine jointly share 40 beds in the adult cardiovascular ward, 28 beds in the pediatric surgery ward, and 16 beds (now 10 beds at work) in the congenital cardiac disease intensive care unit, boasting cardiovascular surgery performance of 600?700 cases a year, making it a global leader as a surgical unit.

Our Physicians

Interim Chairman, Cardiovascular Surgery Department

Shingo Kasahara,
[General cardiovascular surgery, pediatric congenital heart diseases]

Staff

Hidemasa Oh Professor
(Center for Innovative Clinical Medicine)
[Heart failure, regenerative medicine]
Teiji Akagi Associate professor
(cardiovascular intensive care unit)
[Adult congenital heart disease, pediatric congenital heart disease]
Shingo Kasahara Professor [Congenital heart disease]
Sadahiko Arai Lecturer [Congenital heart disease, heart transplant]
Masuda Zenichi Assistant professor [Adult cardiac surgery]
Susumu Oozawa Assistant professor [Vascular surgery, Endovascular Vascular Stent]
Yasuhiro Kotani Assistant professor [Congenital heart disease, adult cardiac surgery]
Yasuhiro Fujii Assistant professor [Vascular surgery, congenital heart disease, adult cardiac surgery]

*Specialty shown in [ ]

Weekly schedule of outpatient surgeons

  Monday Tuseday Wednesday Thursday Friday
Outpatient physicians   Professor Lecturer   Lecturer Lecturer
Clinical sections available by day of the week Morning Vascular surgical outpatient General outpatient Pediatric heart outpatient Adult congenital outpatient   General outpatient Adult congenital vascular surgical outpatient Vascular surgical outpatient General outpatient
Afternoon Adult cardiac surgery Vascular surgical outpatient General outpatient Pediatric heart outpatient Adult congenital outpatient   General outpatient Adult congenital vascular surgical outpatient Vascular surgical outpatient  

Treatment system

The department relocated to a new general clinical building in May 2013. Surgical days increased from four days (six course-hours) a week to every day so that we can perform surgery from 10 to 15 course-hours per week. With this change, the prospective cases of surgery are expected to increase in number. Consequently, the persistent backlog of as many as 200 patients who are now waiting for surgery, is expected to be reduced considerably. Furthermore, now that a long-awaited hybrid operation room has been completed, the department has become an institute that is able to respond to highly advanced medical treatment. The beds of both the ICU and CICU have increased to 18, completing its transformation into a leading institute in Japan.
In the new system, Kasahara lead the team for congenital heart diseases, Associate professor Masuda, who has returned from the Leipzig Cardiovascular Center, leads the team for adult heart diseases, and Assistant professor Osawa leads the team of angioscopic treatments such as vascular surgery and stenting.

Treatment policy

We provide top-level medical care that places the highest value on every patient's life and QOL.

Specialties

  • Surgical Treatments of Congenital Heart Disease
  • Surgical Treatments of Adult Congenital Heart Disease
  • Surgical Treatments of Aorta (Thoracic, Abdominal)
  • Cardioangioscopy
  • Catheter Closure of ASD, Catheter Closure of PDA
  • Endovascular Aneurysm Repair of Thoracic Aorta (TEVAR)
  • Endovascular Aneurysm Repair of Abdominal Aorta (EVAR)
  • Surgical or Catheter Treatments of Obstructive Atherosclerotic Disease
  • Surgical Treatments of Varicose Vein
  • Creation of Vasucular Access
  • Regenerative Therapy of Myocardium

Scope of Target diseases

  • Pediatric congenital heart diseases
  • Adult congenital heart diseases
  • Adult heart diseases (coronary artery, valvular disease)
  • Infective endocarditis
  • Aortic aneurysm (thoracic and abdominal)
  • Dissecting aortic aneurysm
  • Arteriosclerosis obliterans
  • Acute arterial thrombosis
  • Burger’s disease
  • Venous aneurysm
  • Venous thrombosis

Description of medical care

The Department of Cardiovascular Surgery conducts diagnoses and surgical therapy for congenital and acquired heart diseases. Cardiovascular operations conducted by the department are 400?500: the greatest number and the best performance among all national state-run university hospitals. Especially, the performance of congenital heart disease surgeries is top-level nationwide, or worldwide. Many patients, including neonates and infants with complex cardiac anomaly, have been referred to our department from Chugoku and Shikoku districts and from as far afield as Kanto, Kyushu, and overseas. Therefore, in terms of congenital heart diseases, we mainly perform surgeries not only for common diseases such as atrial septal defect, ventricular septal defect, and tetralogy of Fallot, but also for complex heart diseases such as hypoplastic left heart syndrome, single ventricle, and pulmonary atresia and diseases requiring emergency surgery in neonatal life. These severe cases are often diagnosed prenatally because of developed fetal diagnosis, so patients are admitted to the Okayama University Hospital before birth. Because precise diagnosis is necessary for operations, we collaborate with the departments of pediatrics and obstetrics to perform echocardiography, fetal echocardiography, cardiac catheter test, etc.
In terms of adult congenital heart diseases, which are likely to continue increasing in the near future, we perform 100?200 cases of catheter test therapy and surgery annually in cooperation with Dr. Teiji Akagi and others in the Cardiac Care Unit. The acquired heart diseases include valve disease, angina, cardiac infarction, and their resultant complications such as ischemic disease, irregular heartbeat. Therefore, the surgery processes are often combined with procedures of valvuloplasty, artificial valve replacement, coronary artery bypass surgery, and arrhythmic surgeries. With a core of Assistant Professor Masuda, who has returned from the Leipzig Cardiovascular Center in Germany, we have started to provide the latest treatments available anywhere in the world. Vascular diseases include aortic aneurysm (dissecting, thoracic, and abdominal) and aortitis syndrome. When a patient scheduled to undergo artificial blood vessel replacement operation is elderly or has some other disease that suggests a high risk related to surgery, we also introduce intravascular treatment to restore functionality from within the artery using a catheter by combining artificial blood vessels with a stent for reducing the invasiveness. Intravascular treatment cases using the latest hybrid operation unit available world-wide are introduced into new Advanced Medical Center can reasonably be expected to increase in number. Peripheral vascular diseases include arteriosclerotic diseases, which are on the increase, arterial diseases such as Burger’s disease, and venous diseases such as venous aneurysm and venous thrombosis. In addition to bypass operations using artificial blood vessels, non-operative procedures include balloon-expandable stent and stent placement using catheters.
Moreover, we are actively exploring highly advanced medical treatments including regenerative medicine for postoperative severe heart failure by heart transplant and hypoplastic left heart syndrome and auxiliary artificial heart. We also respond to postoperative follow-up for our patients who have undergone the procedures described above in our outpatient clinic service in cooperation with physicians of internal medicine and pediatrics outside and inside our hospital. In terms of the treatments for adult congenital heart diseases, which have been growing steadily recently, we provide treatments for 100?200 patients annually in cooperation with the Cardiac Care Unit, boasting performance and treatment contents that are rated first in Japan. Many patients visit our department from all over the country. Furthermore, adult congenital heart disease outpatient clinics have also started. We offer a fulfilling follow-up system using telemedicine equipment. Catheter treatments for atrial septal defect are conducted at a rate of more than 100 cases per year with the Cardiac Care Unit (CCU) in this year, boasting a number accounting for one-third of cases in Japan and providing superior performance.

For outpatients

Many patients are queued for outpatient care or second opinions from Kasahara. Therefore, when severe cases are examined in succession, your appointment time might be delayed. If your time is strictly limited, please make an appointment early. Please make an appointment after your consultation is over, or by phone. We appreciate your understanding that clinical hours can change according to the number of patients.

Highly advanced/specialized medical treatments

Techniques covered by health insurance programs

  • Multi staged treatments for pediatric congenital heart diseases
  • Valvuloplasty for adult valve disease
  • Intraoperative hybrid therapy for complex cardiac anomaly (stent)
  • Catheter closing operation for atrial septal defect
  • Stenting for thoracic aortic aneurysm
  • Stenting for abdominal aortic aneurysm
  • Cardiac operation using artificial blood vessels with Contegra valve

Techniques designated as highly advanced medical treatments

  • Angiogenesis therapy by bone-marrow cell implantation (cell treatment or regenerative treatment for severe chronic ischemic limb (arteriosclerosis obliterans, Burger’s disease)

Techniques conducted as clinical trial studies

  • Performance research of Revatio 20 mg specific use

Techniques conducted as clinical research

  • Effects of sarpogrelate hydrochloride on intermittent claudication associated with arteriosclerosis obliterans
  • Regenerative medicine for congenital heart disease using intramyocardial stem cells

Main methods for testing and explanation

In the examination division, we have top-class cardiac ultrasonography and catheterization study backed up intensively by the departments of Circulative Pediatrics and the Cardiac Care Unit, putting all our efforts into more certain diagnosis and decision of treatment policy. Furthermore, in the adult division, we collaborate with the Department of Cardiovascular Medicine to produce a diagnosis and start treatments rapidly. Additionally, in terms of the ultrasonography division, detailed examinations have been conducted by two sonographers.

Main testing methods and medical equipment

Artificial heart lung apparatus

The apparatus is necessary for cardiovascular and microvascular surgeries, supporting heart and lung functions during operations. We have also prepared a small circuit, with an in-circuit full ratio that is limited to 200?300 ml to support less-invasive operation without blood transfusion for infants and young children who otherwise would be subject to blood transfusion. In adult patients, cases without blood transfusion because of pre-operative autologous blood donation have been increasing. We have biventricular assist devices such as ECMO and PCPS and auxiliary artificial heart for all cases of severe heart failure. Five artificial heart and lung MEs are assigned permanently to respond to more than 300 cases per year, including open-heart operations, transplant, and emergency cases.

Freezing coagulation device

To reduce the invasiveness and time during an operation for arrhythmic treatment, the device freezes tissues at low temperatures of -80°C or less to remove arrhythmic causes and to prevent the diffusion.

Endovascular treatments (endovascular aneurysm repair (EVAR) etc.)

At Okayama University Hospital, with facilities and physicians certified by the Japanese Committee for Stentgraft Management consisting of 11 academic societies related to thoracic and abdominal aortic aneurysms, we use stentgraft (stent combined with artificial blood vessels) for aneurysm treatment. When a patient is elderly or has some other disease, aneurysm surgery is often risky. Then, the patient can choose non-surgical procedures without laparotomy or thoracotomy.

Intensive Care Unit

Since May 2013, when the new general clinic building was completed, we have been able to perform cardiovascular operations using 2?3 operation rooms every day, which has doubled the number of surgeries. With this, the intensive care unit exclusively for pediatric cardiovascular operations (CCCU) has increased to 12?16 beds and the adult cardiovascular intensive care unit has 6?10 beds. They have enabled us to respond to emergency operations in addition to regular operations on an over three-a-day basis. In addition, patients with severe conditions requiring urgent care can be taken safely from a long distance through a heliport on the roof of the hospital. Many visitors from abroad visit our hospital continually to view our facilities, which rank first or second in Japan.

Cardiac ultrasonography (echocardiographic examination)

It is necessary to diagnose and conduct dynamic function evaluation of heart diseases (in particular pediatric congenital heart diseases) and macrovascular diseases. Because it is sufficiently less invasive to use iteratively, it is effective for child cases and follow up before and after operations. Recent advanced transesophageal echocardiography has improved the precision of testing of lesions and sites, which used to be difficult to examine solely from the body surface.

Cardiac catheter, cardiovascular/coronary imaging tests

Performance of highly accurate operations is important to identify disease names and to evaluate the involved area, severity level, and complicated lesion accurately. Using different tests, which are also called mapping for safe operations, we collaborate with the Department of Pediatrics. For aortic diseases, we offer outpatient contrast study using an intravenous catheter. Two hybrid catheter rooms have been established on the floor of the inpatient ward: one for child patients and one for adult patients. When one includes the hybrid surgical suite room, we can confidently state that we are the first institute with three hybrid units in Japan, which is expected to enable us to provide more highly advanced medical care.