As a core hospital in Kobe City, our basic philosophy is to provide high-quality medical care safely in order to protect the lives and health of citizens. is a required area. In our department, Cardiovascular Surgery are on standby 24 hours a day, 365 days a year, and we have a system that allows us to respond quickly to all diseases in the adult cardiovascular field, including emergency surgery. In addition, as a cardiovascular center, Cardiology Cardiology Cardiovascular Surgery Cardiovascular Surgery closely together. We strive to provide the best possible treatment for each patient.
With regard to surgery, we strive to provide treatments that place the least possible burden on the body and minimize the risk of complications. increase. Catheterization or minimally invasive surgery may be appropriate, while traditional open chest or abdominal surgery may be appropriate for long-term peace of mind. Even for the elderly aged 80 and over, we have increased the safety of surgery by paying close attention to the protection of various organs, including heart and aorta surgery.
Immediately after surgery, you will be treated with Intensivist. Taking advantage of being a general hospital, doctor from each clinical department, such as Neurology, Neurosurgery, and diabetes physicians, join the treatment as needed. In addition to doctor, we also provide multidisciplinary team medical care, including nurses, clinical engineers, rehabilitation department staff, pharmacists, nutritionists, and radiological technologists.
When you think of heart surgery, you may have an image of scary or difficult surgery. Recently, however, surgical techniques have improved, minimally invasive surgery has become possible, and post-operative management has also improved, making it possible for everyone, including the elderly, to undergo surgery with peace of mind. . There are many diseases that are directly linked to life, so I hope that you will not be too afraid and will do your best to undergo the surgery and overcome the illness. After surgery, most people can lead a normal life. We hope that you will not limit your life more than necessary, and will live a fulfilling life while paying attention to your lifestyle habits such as diet and exercise.
I would like to try to explain as clearly as possible so that you can decide the treatment method after convincing. Please feel free to visit us, including consultation on treatment methods.
valvular surgery
For aortic stenosis, we comprehensively judge age, comorbidities, etc., and select transcatheter aortic valve placement (TAVI) or traditional open-heart aortic valve replacement. The first choice for patients over 80 is transcatheter aortic valve placement, but if concurrent surgery is required for complications, we perform open-chest surgery.
For mitral valve regurgitation, we perform valvuloplasty in more than 95% of cases for mitral valve regurgitation caused by the mitral valve itself. If there are no problems with heart function or respiratory function, and blood vessels are normal, we perform a small right thoracotomy (MICS) without incising the sternum. There is no exercise restriction after discharge, and early return to society is possible.
For secondary mitral regurgitation with decreased cardiac function, age and comorbidities are comprehensively judged, and percutaneous mitral valve coaptation repair (Mitra clip) or open heart surgery is performed. I am choosing.
For aortic regurgitation associated with aortic root dilatation, autologous aortic valve that avoids complications such as embolism and infection related to artificial valves and does not require oral anticoagulant (warfarin) We are actively performing self-valve-preserving base replacement surgery that preserves the
coronary artery bypass surgery
More than 90% of cases of coronary artery bypass grafting alone are performed off-pump (without the use of a heart-lung machine, under heartbeat) at our hospital. Adverse effects associated with a heart-lung machine can be avoided, and the benefits are particularly significant in high-risk patients with cerebrovascular disease and renal dysfunction.
We actively use two internal mammary arteries with good long-term patency. The great saphenous vein is harvested using a no-touch technique that leaves the surrounding tissue intact and has been reported to have good long-term patency comparable to that of arterial grafts. Although there is a disadvantage that the incision is the same size as before, good long-term patency comparable to that of arterial grafts has been reported, and we believe that this outweighs the disadvantages. If arteriosclerosis of the legs (arteriosclerosis obliterans) is complicated, the possibility of wound complications is high, so we use an endoscope to collect samples using only two small incisions.
aortic surgery
Considering the lesion site, comorbidities, age, etc., we choose artificial blood vessel replacement by thoracotomy/laparotomy and stent graft implantation. Even for the elderly aged 80 and over, the safety of surgery is enhanced by paying close attention to the protection of various organs during surgery. As a core hospital in Kobe City with a critical care center, we perform emergency operations for aortic aneurysm rupture and acute aortic dissection.
peripheral vascular surgery
In lower extremity bypass surgery for arteriosclerosis obliterans, we try to use autologous veins with good long-term patency as much as possible. For lower leg lesions, which are often the cause of severe lack of blood flow, we actively perform bypass surgery to blood vessels in the lower leg and legs using autologous veins in an effort to prevent amputation of the lower limbs. Endarterectomy is performed for common femoral artery lesions. We also perform thrombectomy for acute arterial occlusion and internal shunt construction for maintenance dialysis. For varicose veins in the lower extremities, we perform endovascular cauterization, varicose vein resection with a very small skin incision (stub avulsion method), high ligation, and sclerotherapy, depending on the lesion and the patient's wishes. .
Medical record
Main diseases targeted for medical treatment
- Angina pectoris/myocardial infarction: coronary artery bypass surgery, ventricular aneurysmectomy, left ventricular angioplasty
- Valvular disease: aortic valve replacement (thoracotomy), TAVI (transcatheter aortic valve placement), mitral valvuloplasty,
Mitral valve replacement, tricuspid valve replacement, tricuspid valve replacement, MICS (right minithoracotomy) - Arrhythmia: Maze surgery, pulmonary vein isolation, left atrial appendage resection/left atrial appendage closure
- Cardiac Tumors: Cardiac Lumpectomy
- Constrictive pericarditis: pericardiectomy
- Aortic aneurysm/aortic dissection: artificial blood vessel replacement, stent graft insertion
- Arteriosclerosis obliterans: leg bypass surgery, endarterectomy
- Acute arterial occlusion: thrombectomy
- Lower extremity varicose veins: endovascular cauterization (high frequency/laser), endovascular adhesive treatment (glue treatment),
Varicose vein resection (stub avulsion method), high ligation, sclerotherapy - Internal shunt construction (for dialysis)
Departmental statistics
Main diseases/treatments
coronary artery
(1) Illness
Atherosclerotic masses deposit on the walls of the coronary arteries, which are the blood vessels of the heart, and narrow or block the coronary arteries, which is collectively called "ischemic heart disease." A condition in which the blood flow to the heart muscle (myocardium) is reduced is called angina pectoris, and a condition in which the blood flow to the heart muscle is completely cut off and the myocardium dies is called a myocardial infarction. Patients with diabetes mellitus may be asymptomatic, and this condition is called asymptomatic myocardial ischemia. Arteriosclerosis is a condition in which cholesterol and calcium are deposited in blood vessels due to lifestyle-related diseases such as hypertension, hypercholesterolemia, diabetes, and smoking.
About 10% of people who develop an acute myocardial infarction are life-threatening. In addition, even if the patient is alive, the damaged myocardium stops functioning and the function of the heart deteriorates, causing heart failure or arrhythmia.
② Treatment
(1) Drug treatment
If the disease progresses, catheterization (percutaneous coronary angioplasty) or coronary artery bypass surgery may be required.
(2) Catheterization (percutaneous coronary angioplasty)
This is a method that uses a catheter (thin tube) and a balloon or stent (wire mesh) to dilate narrowed or blocked coronary arteries to improve blood flow. Catheterization is less invasive than coronary artery bypass surgery. I'm doing it in Cardiology.
(3) Coronary artery bypass surgery
A blood vessel is taken from another part of the body and connected to the coronary artery beyond the narrowed or blocked part to improve blood flow to the heart. Left main coronary artery lesion (lesion at the root of the left coronary artery), lesion in the proximal left anterior descending artery (lesion at the root of the left anterior descending artery), trivessel lesion (when all three coronary arteries have lesions), and severe calcification Bypass surgery lasts longer than catheter treatment for patients with lesions (coronary arteries that are very stiff), diffuse lesions (coronary artery lesions that are long), diabetes mellitus, and those with reduced heart function. In the long term, they have a lower risk of having a heart attack and live longer.
Chest artery (internal mammary artery), leg vein (great saphenous vein), hand artery (radial artery), stomach artery (gastroepiploic artery), etc. Connect to the coronary artery ahead of the affected area to improve blood flow to the heart.
The thoracic artery (internal mammary artery) is the blood vessel that lasts the longest in the long term, and our department actively uses the two internal mammary arteries. At our department, the leg vein (great saphenous vein) is harvested using a no-touch technique that leaves the surrounding tissue attached, which has been reported to have good long-term patency.
In our department, in about 90% of cases, we perform coronary artery bypass surgery without using a heart-lung machine (off-pump). If valvular disease surgery and thoracic aorta surgery are required at the same time, the surgery is performed using a heart-lung machine.
* Cardiopulmonary machine
A heart-lung machine is a machine that has the functions of the heart and lungs, taking oxygen into the blood and pumping the blood throughout the body. It is necessary for valvular disease and thoracotomy for thoracic aorta.
valvular disease
① What is valvular disease?
The heart has four chambers.
Blood returning from the whole body flows in the order of "right atrium" → "right ventricle" → "lungs" → "left atrium" → "left ventricle". In the lungs, carbon dioxide is released and oxygen is taken in. Blood is pumped throughout the body from the left ventricle.
Each room has a door called a "valve" that prevents blood from flowing backwards. The right atrium has the tricuspid valve, the right ventricle has the pulmonary valve, the left atrium has the mitral valve, and the left ventricle has the aortic valve.
A condition in which the valve fails due to various causes is called “valvular disease”. A condition in which the valve does not open sufficiently to allow blood to flow is called "stenosis," and a condition in which blood flows backward because the valve does not close properly is called "regurgitation," which puts a strain on the heart. Become. As valvular disease worsens, heart failure can occur, leading to difficulty breathing and swelling of the face and limbs.
② Treatment
(1) Drug treatment
If valvular disease is mild or moderate, drug treatment is given. When valvular disease becomes severe, valvuloplasty, valve replacement, and TAVI (transcatheter aortic valve replacement) are performed.
(2) TAVI (transcatheter aortic valve replacement)
This is an operation to place an artificial valve with a catheter (thin tube) without opening the chest for aortic stenosis. Since the chest is not opened and no artificial heart-lung machine is used, there is little burden on the body. The long-term durability of prosthetic valves is still unknown.
TAVI is suitable for the very elderly (over 80 years old), those in poor general condition, and those with severely reduced lung and liver function.
(3) Valvuloplasty
Open heart surgery includes “valve replacement surgery” to replace with an artificial valve and “valvuloplasty” to repair your own valve.
For mitral regurgitation, valvuloplasty is said to preserve heart function, prevent valve infections, and allow patients to live longer. However, if valvuloplasty is performed, regurgitation may remain or may recur in the future, necessitating reoperation. If the valve is severely damaged, valve replacement surgery may be required.
In the case of "tricuspid regurgitation", "valvuloplasty" is often possible in most cases, but "valve replacement" is necessary if the valve is severely destroyed.
(4) Valve replacement surgery
Surgery to replace an artificial valve. In particular, it is an operation performed for "aortic valve stenosis", "aortic valve regurgitation", and "mitral valve stenosis".
There are two types of prosthetic valves: mechanical valves and biological valves.
The "mechanical valve" is made of carbon, which is highly durable and lasts longer. However, thrombi (blood clots) are likely to form in the artificial valve, and if a thrombus is formed, cerebral infarction may occur and the artificial valve may not work. Taking warfarin can cause problems such as cerebral hemorrhage and bleeding from the stomach and intestines.
A biological valve is made from bovine heart membranes or pig heart valves. After 10 to 20 years, prosthetic valves may deteriorate and may require reoperation. Blood thinners (warfarin) can be discontinued 3 months after surgery if not needed for other reasons, such as atrial fibrillation.
(5) Right minithoracotomy (MICS)
If the blood vessels are in good condition and the general condition is good, valvular surgery is performed by right minithoracotomy (MICS).
① What is atrial fibrillation?
In a normal heart, the myocardium contracts regularly in the order of the atrium (right atrium/left atrium) → ventricle (right ventricle/left ventricle). Atrial fibrillation is a condition in which the atria move very quickly and erratically.
Atrial fibrillation causes blood to stagnate in the left atrium, making it easier for blood clots (thrombi) to form, which can lead to cerebral infarction. In addition, blood stagnates, making heart failure more likely.
② Treatment
(1) Drug treatment
(2) Cardioversion
(3) Catheter ablation
Using a catheter (thin tube), the electrical circuit of the heart that causes arrhythmia is burned out by high frequency or cryocoagulation. I'm doing it in Cardiology.
(4) Maze surgery, pulmonary vein isolation (by thoracotomy)
If you are undergoing heart surgery and you have atrial fibrillation, you may undergo arrhythmia surgery at the same time. High frequency or cryogenic coagulation burns out the electrical circuit of the heart that causes arrhythmia. Paroxysmal atrial fibrillation, which occasionally causes atrial fibrillation, is easily cured by arrhythmia surgery, while permanent atrial fibrillation, which persists for a long period of time, is less likely to be cured.
(5) Left atrial appendage resection/left atrial appendage closure
When atrial fibrillation occurs, blood clots (thrombi) are more likely to form in the left atrial appendage, which is shaped like an ear. Because thrombi can cause cerebral infarction, patients with atrial fibrillation should undergo surgery to prevent future cerebral infarction by removing or closing the left atrial appendage to prevent thrombi from forming. increase.
aortic disease
①What is a thoracic aortic aneurysm?
The aorta is the largest blood vessel in the body and is the passageway for blood to be pumped out from the heart.
Blood pumped from the heart flows as follows.
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Aortic root: Branches blood vessels (coronary arteries) to the heart
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ascending aorta
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Aortic arch: Branches the blood vessels that lead to the brain and arms
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descending aorta
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Abdominal aorta: Branches blood vessels to the stomach, intestines, liver, and kidneys
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Iliac aorta: Branches blood vessels to the legs, intestines, and buttocks
The aorta in the chest is collectively called the thoracic aorta.
If the aorta becomes large enough to form an aortic aneurysm, the risk of rupture increases. Rupture of an aortic aneurysm causes heavy bleeding and is often fatal before reaching the hospital. In addition, even if the patient is taken to the hospital by ambulance after the rupture, the condition is often deteriorating. higher. Therefore, if the aortic aneurysm has grown to a certain size, it should be operated before it ruptures, even if there are no symptoms.
Aortic aneurysms are often caused by arteriosclerosis (diabetes, hypertension, hyperlipidemia, smoking, aging, etc.), and other causes include dissection, infection, and inflammation.
② Treatment
(1) Thoracic aorta graft replacement (via thoracotomy)
An incision is made in the center or left side of the chest to replace the aortic aneurysm with an artificial blood vessel.
When replacing the ascending aorta or arch aorta with an artificial blood vessel, it is necessary to stop the heart before performing surgery. Inject to stop the heart. Also, in order to protect each organ (brain, heart, abdominal organs, spinal cord, etc.), body temperature is lowered during surgery.
* Cardiopulmonary machine
A heart-lung machine is a machine that has the functions of the heart and lungs, taking oxygen into the blood and pumping the blood throughout the body. It is necessary for valvular disease and thoracotomy for thoracic aorta.
In this method, a small incision is made at the base of the foot, and a catheter (thin tube) is used to place an artificial blood vessel "stent graft" with wire mesh. The advantage is that it is less invasive than open heart surgery. Often suitable for descending aortic aneurysms. It is often not suitable for ascending aortic aneurysms or aortic arch aneurysms, and open heart surgery is often suitable.
①What is aortic dissection?
The aorta is the largest blood vessel in the body and is the passageway that carries blood away from the heart.
An “aortic dissection” is a condition in which the inside of the aorta splits and the wall of the aorta splits, allowing blood to enter the wall. It often develops suddenly (called "acute aortic dissection"), the thinning of the outer wall of the aorta makes it unbearable for high blood pressure, and there is a risk of rupture of the aorta. As a result, blood does not flow sufficiently through the blood vessels that branch off from the aorta, and damage to various organs (cerebral infarction, myocardial infarction, blood flow disturbance in the limbs, intestinal blood flow disturbance, renal failure, etc.) can occur. It is a life-threatening disease.
If there is a dissection in the ascending aorta (Stanford type A aortic dissection), the aorta is likely to rupture and may be life-threatening due to cardiac tamponade (blood pooling around the heart causing pressure) It is highly sensitive and often requires early surgery. Backflow may occur in the door "aortic valve" attached to the exit of the heart.
If there is no dissection in the ascending aorta (Stanford type B aortic dissection), the course is often observed with blood pressure control and rest during the acute phase. However, if blood flow to a leg, intestine, or other area is reduced, or if an aorta ruptures, emergency surgery is needed. In the long term, a dissected descending aorta or abdominal aorta may enlarge, and if the aorta becomes large enough, it may rupture and require surgery. Blood pressure control is important to prevent aortic enlargement.
① What is an abdominal aortic aneurysm?
The aorta is the largest blood vessel in the body and is the passageway that carries blood away from the heart.
Blood flows from the abdominal aorta to the legs in the following ways:
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Iliac artery: Branches blood vessels leading to the intestines and buttocks
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Femoral artery: goes to the leg
If the aorta becomes large enough to form an aortic aneurysm, the risk of rupture increases. Rupture of an aortic aneurysm causes heavy bleeding and is often fatal before reaching the hospital. In addition, even if the patient is taken to the hospital by ambulance after the rupture, the condition is often deteriorating. higher. Therefore, if the aortic aneurysm has grown to a certain size, it should be operated before it ruptures, even if there are no symptoms.
Aortic aneurysms are often caused by arteriosclerosis (diabetes, hypertension, hyperlipidemia, smoking, aging, etc.), and other causes include dissection, infection, and inflammation.
② Treatment
(1) Abdominal aortic graft replacement (by laparotomy)
An incision is made in the middle of the abdomen and the aortic aneurysm is replaced with an artificial blood vessel.
Long-term problems are rare, and treatment is certain.
(2) Abdominal aorta stent graft implantation
This is a method in which a small incision is made at the base of the foot and a catheter (thin tube) is used to place an artificial blood vessel "stent graft" with wire mesh. It is less invasive than open surgery.
However, despite treatment, the abdominal aortic aneurysm may expand in the future, requiring regular check-ups. If the aortic aneurysm enlarges, additional treatment (catheterization or laparotomy) may be required.
①What is arteriosclerosis obliterans?
Arteriosclerosis obliterans is a condition in which arteriosclerosis narrows or blocks blood vessels in the legs, resulting in reduced blood flow to the legs. Arteriosclerosis is a condition in which cholesterol and calcium are deposited in blood vessels due to lifestyle-related diseases such as hypertension, hypercholesterolemia, diabetes, and smoking.
Inability to walk long distances without rest, pain in the legs even when resting, and ulcers in the skin of the legs, if the disease progresses further, necrosis of the legs and the possibility of amputation of the legs. there is.
② Treatment
(1) Exercise therapy
(2) Drug therapy
(3) Catheterization
(4) Bypass surgery
In our department, we try to use autologous veins with good long-term patency as much as possible. For lower leg lesions, which often cause severe lack of blood flow, we actively perform bypass surgery to blood vessels in the lower leg and legs using autologous veins to prevent amputation of the lower extremities. Endarterectomy is performed for common femoral artery lesions.
① What is acute arterial occlusion?
It is a disease that causes sudden blockage of arteries in the hands and feet, causing pain, pallor, hypoesthesia, and motor paralysis. Amputation of hands and feet is likely to be required and early treatment is required.
② Treatment
(1) Thrombectomy
Surgery to remove a blood clot (thrombus) with a balloon catheter
(2) Catheterization
(percutaneous thrombus aspiration therapy, percutaneous angioplasty, transcatheter thrombolysis, etc.)
Varicose vein
①What is lower extremity varicose veins?
The paths that carry blood from the body back to the heart are called veins. There are two types of leg veins: “deep veins” that run deep in the legs and “superficial veins” that run on the surface of the legs. Normally, blood flows from superficial veins to deep veins, and a one-way valve is attached between them to prevent backflow of blood. When the one-way valve is broken and blood flows backward from the deep veins to the superficial veins, the superficial veins dilate and become ``varicose veins''. Weak legs, cramps, swelling, eczema and pigmentation, hardening of the skin, and ulceration of the skin.
Diagnosis is made by examining the veins of the lower extremities with ultrasonography.
For mild cases, treatment includes lifestyle changes and compression with elastic stockings. Surgery should be considered if any of the above symptoms occur. Surgery is performed as a day case or with an overnight hospital stay.
Consultation days are every Thursday and reservations are accepted on the same day, so please feel free to contact us.
② Treatment
(1) Endovascular ablation
This is a treatment method in which a catheter (thin tube) is inserted into a vein that is causing reflux, and the vein is burnt with high frequency or laser to block the vein and prevent blood from flowing backward.
(2) Intravascular adhesive treatment (glue treatment)
This is a treatment method in which a catheter (thin tube) is inserted into a vein that is refluxing, and glue is injected into the vein to block the vein and prevent the backflow of blood.
(3) Varicose vein resection (stub abulgeon method)
A very small (1-2 mm) incision is made in the skin, and the varicose veins are excised by pulling out the varicose veins with hooks.
(4) Vein removal surgery (stripping surgery)
The retrograde vein is withdrawn when endovascular treatment is not suitable.
(5) High ligation
When endovascular treatment or vein extraction is not suitable, the base of the vein is tied to prevent backflow of blood.
(6) Sclerotherapy
(7) elastic stockings
Used for mild cases
clinical research
Our department conducts clinical research to solve various clinical questions. Observational research is conducted without direct consent, but with this notice. In addition, intervention studies and observational studies that have been reviewed and approved by the hospital's clinical research ethics committee are conducted after obtaining the individual patient's consent.
Major clinical studies (including observational and intervention studies)
| Research subject name | Person in charge of our hospital | Explanatory text (PDF) |
| Surgery and treatment information database project in the National Clinical Database (NCD) | Jiro Ezaki | |
|---|---|---|
| A national questionnaire survey on aortic valvuloplasty | Jiro Ezaki | |
| Distant results of surgical repair for mitral valve perivalvular regurgitation | Kazufumi Yoshida | |
| Remote results of posterior leaflet patch augmentation for mitral regurgitation | Kazufumi Yoshida | |
| Remote results of flexible band annulus closure for functional severe tricuspid regurgitation | Kazufumi Yoshida | |
| Prevention of local recurrence after surgical resection for primary cardiac sarcoma | Kazufumi Yoshida | |
| Evaluation of the efficacy of hybrid treatment combining thoracic aortic stenting and thoracoabdominal aortic graft replacement for extensive thoracoabdominal aortic aneurysm | Kazufumi Yoshida | |
| A multicenter study on the usefulness of papillary muscle-mediated mitral valvuloplasty for severe ischemic mitral regurgitation | Jiro Ezaki |
To local teachers
In our department, Cardiovascular Surgery are on standby 24 hours a day, 365 days a year, and we have a system that allows us to respond quickly to all diseases in the adult cardiovascular field, including emergency surgery. In addition, as a cardiology center, we work closely with Cardiology and hold conferences with Cardiology twice a week. Once a week, we examine the individual cases before surgery while viewing the images so that we can select the optimal treatment method. However, we are reexamining treatment methods. Cooperation with each department other than Cardiology is also good, and one of the great strengths of our hospital is that we can treat patients intensively.
Even for the elderly aged 80 and over, we have improved the safety of surgery, including open-heart surgery, by paying close attention to the protection of various organs during surgery.
Please feel free to contact us, including cases where you are unsure about surgery adaptation.
Jiro Ezaki
Director Cardiovascular Surgery
Referral method and treatment flow
For introductions to our department, please use the FAX reservation or web reservation described on our website. For online reservations, a special ID and password will be distributed from here, so you can access the dedicated site from there and make a reservation directly to the vacant slot.
In addition, we are available 24 hours a day for urgent cases or if you wish to consult directly.
After your visit to our hospital, we will contact you as soon as a treatment policy is decided. Generally, you will be admitted to the hospital 1-2 days before the surgery and will be discharged from the hospital 10 days to 2 weeks after the surgery. Two to three months after discharge from the hospital, we will check the postoperative course in our outpatient department, and after the patient has stabilized, we will refer him back to the doctor who introduced him.
For young doctor considering training at our hospital
The Department performs 250 to 300 cases of open heart surgery (cases using artificial heart-lung + OPCAB), 30 to 50 cases of stent graft insertion, 30 to 40 cases of abdominal aortic artificial vessel replacement, and about 100 cases of peripheral vascular surgery annually. Kobe City The Department is equipped with an emergency center at a major hospital in the United States, and has extensive experience in emergency surgeries such as aortic dissection and aortic aneurysm rupture, and also performs many small right open thoracic surgery (MICS), thoracoabdominal aortic artificial vessel replacement and autologous valve-sparing aortic root replacement surgeries. We are the first institution to perform transcatheter aortic valve implantation (TAVI) for aortic stenosis Hyogo Prefecture and have just completed over 500 cases in total. We also perform thoracic and abdominal stent graft insertion procedures jointly at Cardiovascular Surgery and Cardiology, providing experience in minimally invasive surgery. Thus, the hospital is unique in that it offers experience in a wide variety of adult Cardiovascular Surgery surgeries without bias in any field. In addition, we have abundant peripheral vascular surgeries such as thrombectomy for acute arterial occlusion, angioplasty for pseudoaneurysm, internal shunt creation, leg bypass surgery for arteriosclerosis obliterans, and varicose vein surgery, Senior Resident can also be performed.
On Tuesdays, we hold an aortic conference and a valvular disease conference jointly with Cardiology every other week on Tuesdays to review cases after aortic surgery and valvular disease surgery. On Wednesdays, we hold a case review meeting with Cardiology to determine the optimal treatment policy for each case as a heart team. On Thursdays, M&M and literature readings are held, and on Fridays, doctor conferences are held with Anesthesiology, clinical engineers, and nurses to discuss the next week's surgical cases. M&M is performed once a month with an intensive care physician, and we review cases of death and complications. By giving presentations at conferences, Senior Resident can practice presentations and learn about general examinations, treatments, surgical procedures, and postoperative management, including guidelines.
In the 2nd or 3rd year, students are rotated for half a year at Amagasaki General Medical Center Cardiovascular Surgery, where they can learn about Cardiovascular Surgery surgery at another facility and experience surgery performed by various surgeons. In our program, out of the experience required to become Board Certified Surgeon in surgery, surgical fields other than Cardiovascular Surgery can be completed in the shortest possible time, and it is possible to spend a large period of time in Cardiovascular Surgery Senior Resident in the three years of majoring. It is a program that allows students to experience enough cases as a preparatory stage to acquire Cardiovascular Surgery specialist.
We also have a policy of actively participating in academic conferences and giving presentations. At academic conferences, you can acquire the latest knowledge, learn related knowledge when preparing for presentations, and have opportunities to give presentations at presentations.
As an initiative for work style reform, we are adding sharpness between on and off. Nights, Saturdays, Sundays, and holidays are on a turn system. In addition, the next day after the duty, we will be able to go home by noon. There are many emergency surgeries, but we have a system that allows us to take time off.
