ASOURCE Times

One of the best surgical results in Japan

This hospital was established in Shinjuku in 1977 as a cardiovascular hospital by Dr. Shigeru Sakakibara, a pioneer of cardiac surgery in Japan. In 2003, it was newly built and relocated to the current city of Fuchu, and started as a community-supported specialized hospital (320 beds) in the Tama area centered on cardiovascular medical care and emergency medical care. We provide cutting-edge, highly acute medical care centered on.

Approximately 90 doctors such as cardiologists and cardiovascular surgeons (adults and children) and 330 nurses are available. The number of adult cardiac surgeries is 800 to 900 per year, and the number of coronary intervention treatments is per year. There are about 1,000 cases. Transcatheter Aortic Valve Implantation (TAVI), in which an artificial valve is attached to the heart using a catheter, exceeds 220 cases. The number of pediatric cardiovascular surgery exceeds 400 per year, and all of them can be said to be the top achievements in Japan.

Elderly people with many combined surgeries

As a recent trend, the number of elderly people with heart disease is increasing, and cases of coronary artery disease and valvular disease are conspicuous. In these cases, surgery and internal medicine may work together to perform bypass surgery and TAVI in parallel in a hybrid operating room. Surgery is a minimally invasive cardiac surgery (MICS) that has a small wound and does not burden the body. For the very elderly, we are also implementing new treatments such as leadless pacemakers and subcutaneous implantable cardioverter-defibrillators that do not place leads in the heart and vascular system.

In 2014, we opened an obstetrics and gynecology department with the aim of providing a delivery facility where you can give birth with peace of mind even if you have heart disease. It is not uncommon for women to have surgery for congenital heart disease in their childhood to become adults, get married, and wish to give birth. Even if a child's heart disease is suspected, seamless treatment is possible from the fetal period to the postnatal period. Obstetricians and gynecologists, pediatric cardiovascular surgeons, pediatric cardiac surgeons, nurses, midwives, etc. work as a team to provide detailed medical care.

In 2010, the Acute Aorta Super Network was established in the Tokyo CCU Network, and our secondary emergency hospital is also actively accepting patients as an emergency aorta priority hospital. Acute aortic dissection has a high mortality rate and requires prompt surgical treatment. There are some cases of death during transportation to. Improvements that enable flexible response are desired.

In addition, we are conducting clinical research on regenerative medicine that uses stem cells extracted from heart tissue for the treatment of heart failure. The first patient has been confirmed to have improved cardiac function, and the second patient has just completed treatment and is observing the progress.

From this fall to home medical care support

Our hospital is closely coordinating medical examinations with nearby practicing teachers, but in the future, as the baby boomer generation becomes the late-stage elderly one after another, heart failure that shifts to the terminal stage while repeating hospitalization and discharge will increase rapidly. It will be difficult to deal with community medicine. Looking ahead to the so-called “heart failure pandemic,” we decided to embark on a home care support project as part of the hospital's functions in order to meet such social needs. We will tie up with a professional group of home-visit medical care that is strong in the cardiovascular field, and will start around this autumn. The office will be located in the hospital, and we would like to build a new model that allows home doctors and in-hospital doctors to share patient medical information and respond organically.

The "Basic Law for Stroke and Cardiovascular Disease Countermeasures" enacted in December last year aims to comprehensively improve the medical system and social system for stroke and heart disease, but it deteriorates with repeated hospitalizations and discharges for a long time. It is also an important goal to change the disease model of heart failure, which is the death after hospitalization. In the past, there were many cases where hospital treatment and home treatment were performed separately, but we hope that our organic efforts can contribute to the creation of a community that does not require re-hospitalization. I would like to spread it nationwide as a model case for regional cooperation in the cardiovascular field.

Work sharing and sharing through task shifting / task sharing

Reform of working styles for doctors is being debated, but overworking doctors is a fact, and it is necessary to divide or transfer duties between doctors and other occupations. As part of this, we plan to increase the number of nurse practitioners, and in the future, we would like to share the work by having them engage in post-surgical care and emergency triage. ..

There is a disease called Takayasu's arteritis, which is a designated intractable disease and a type of collagen disease, but it is often misunderstood that symptoms appear only in the aorta, and it is often overlooked. I have been involved in the medical care of many patients with Takayasu's arteritis for many years. Accurate diagnosis is required for early treatment, and we would like to focus on further enlightenment activities.