What was the catalyst to begin your current research?

Noticeable heart enlargement is often observed at the end stage of heart failure. In cases where the cause of the disease is the heart muscle itself, cardiac transplantation is the final treatment. However, there is a limited number of donor hearts available, particularly in Japan, and even though capabilities of implantable VADs have improved drastically, the three major complications of thrombosis, hemorrhage, and infection have not been fully resolved, therefore leaving autologous heart transplant surgeries, such as left ventricular reconstruction surgery, as the expectation,. However, the Batista procedure, which became famous on TV, is now a surgery that cannot be recommended according to guidelines in Western countries. We are therefore conducting overlapping surgeries, which we have developed independently, through which we have attempted to add to the scientific discussion regarding how to decide in which cases autologous heart surgery, artificial heart implantation, or heart transplantation should be chosen.

Figure 1  Overlapping surgeries developed by our department

 

 

DuraHeart

EVAHEART

 

HeartMate II

JARVIK2000

 

What kind of research do you do?

We believe pre-surgery clinical information to be of critical importance, and in cases of severe heart failure, aggressively conduct PET, ultrasound cardiography, scintigraphy, and MRIs in order to examine localization of lesions and preliminary function of the residual myocardium. As there are few cases of autologous heart surgery as treatment for severe heart failure, I established and became a representative of the "Japan Severe Heart Failure Surgery Study Group,” through which a nationwide, multi-center study has been launched. From Japan to the world, I attempt to gather evidence of ideal heart failure surgical treatment systems, including autologous heart surgeries, such as combination of mitral valve surgery, coronary artery surgery, and left ventricular reconstruction surgery, as well as VADs and heart transplants.

 

What is your next goal?

Surgery in our department is very versatile and is constantly evolving, where we pursue a number of autologous valve surgeries, such as complex cardiac malformation surgery on newborns, video assisted minimally invasive surgery, and aortic valvuloplasty. We also perform aortic aneurysm surgery using a less invasive stent graft, and endoarterectomy for thromboembolic pulmonary hypertension. We plan to pursue collaborative research with Osaka University on regenerative medicine as a treatment for the heart muscle itself, which might become weakened during autologous heart surgical treatment for severe heart failure.

 

References

(1)  "Heart and Blood Vessels Surgery Techniques III  Coronary Artery / Heart Muscle Diseases (Shinzo kekkan geka tekunikku III  kandoumyaku shinkinshikkan hen)" Supervised by Yoshiro Matsui, Medicus Shuppan (2009)

"Surgery for Cardiac Valvulopathy (Shinzo benmakushou no geka)" Edited by Tatsuta Arai Chapter 8－4 Overlapping Type Left Ventricular Reconstruction Surgery, Papillary Muscle Connecting Surgery, and Mitral Valve Formation Surgery - (Yoshiro Matsui) Igaku-Shoin (2007)