481
2022年6月現在
481
2022年6月現在
Valvular heart disease is difficult to recognize because mild symptoms such as shortness of breath, palpitation, and tiredness gradually appear.
When it is first discovered after severe symptoms such as fainting, or
Heart murmurs may be pointed out and found during auscultation at the time of examination.
A condition in which a valve in the heart is damaged and cannot fulfill its original role is called valvular heart disease. There are two types of valvular heart disease: "incomplete closure" in which the valve closes incompletely and regurgitates, and "stenosis" in which the valve opens poorly and impedes blood flow. The most common is "mitral regurgitation." "Insufficiency" and "Aortic valve stenosis".
Estimated number of patients with valvular heart disease
Aortic stenosis, in which the aortic valve becomes stiff and difficult to open, has a long asymptomatic course, and it is said that about half of the patients who develop symptoms die within two years. ..
[Image courtesy]
* 1 Edwards Life Sciences Co., Ltd.
* 2 Medtronic Japan Co., Ltd.
Treatment for aortic stenosis depends on the progression of the condition.
If the symptoms are mild, medical treatment with drugs is selected, but it is intended to relieve the symptoms or slow the progression, not to radically improve the narrowed valve.
Therefore, replacing the valve is the only curative treatment for severe stenosis.
TAVI offers treatment options for elderly and critically ill patients who have previously given up treatment.
It is also offered as one of the treatment options for valvular disease at Tobu Hospital
Patients who have difficulty in surgery due to age-related weakness or risk of other diseases
It is now available as a new treatment option.
Less invasive (less pain and less bleeding) compared to traditional surgery
The length of hospital stay can be expected to be short.
A catheter is used to place a prosthetic valve in the patient's heart without opening the chest or stopping the heart.
It has the advantage of being less burdensome to the body than conventional surgery.
There are two treatments for valvular heart disease: drug treatment and valve replacement by replacing the artificial valve, but surgical valve replacement is the most common treatment for radical treatment. However, since valve replacement is a thoracotomy that involves inserting a scalpel into the body, it is a heavy burden for the elderly and those with chronic illnesses, and there are cases where the surgery is postponed.
As the name implies, TAVI uses a "catheter". A catheter is a thin tube that is inserted into a blood vessel to test and treat heart and blood vessel diseases.
Since it is inserted from a part of the body, there is no need to make a large incision in the chest, and no artificial heart-lung machine is required, so there is an advantage that the burden on the body is less than that of conventional surgery. Elderly, or those who are chronic disease in the heart and brain, such as it is bad respiratory function, Surgery risk in surgery is suitable for high patients. In heart disease, catheters are used in coronary surgery and aortic aneurysm treatment.
Similar to these treatments, in TAVI, a folded artificial valve (biological valve) and a balloon are carried from the artery at the base of the foot to the heart with a special catheter, and the balloon is inflated and attached to the position of the aortic valve. I will.
Tobu Hospital, the doctor chooses the method that suits the patient's condition.
Both approaches are less physically demanding and can treat the aortic valve.
A catheter with a folded artificial valve (biological valve) and a balloon is inserted through the artery at the base of the foot.
When the biological valve reaches the position of the aortic valve, the balloon is inflated and the biological valve is opened and placed.
After indwelling, remove the catheter.
A catheter with a biological valve folded to the thickness of a pencil is inserted through the femoral artery at the base of the thigh and carried to the heart.
Video courtesy of Edwards Lifesciences KK
Video courtesy of Medtronic Japan Co., Ltd.
A small incision is made between the ribs, from which a catheter with a folded bioprosthetic valve is inserted through the tip of the heart (apex).
Video courtesy of Edwards Lifesciences KK
Make a small incision in the chest (median sternotomy,
Or intercostal thoracotomy) from the ascending aorta
Insert the biological valve.
Make a small incision in the chest and from the subclavian artery
Pass the catheter through.
Hybrid operating room in the Tobu Hospital
supports various surgical procedures from endovascular treatment to laparotomy and thoracotomy.
It is also characterized by the uninterruptible power supply so that treatment can be continued even in the event of a disaster.
Hybrid operating room in the Tobu Hospital
From endovascular treatment to laparotomy and thoracotomy
Corresponds to various surgical techniques.
Uninterruptible power supply so that treatment can be continued even in the event of a disaster
It is also a feature that it has been realized.
TAVI is a catheter treatment that is less burdensome to the body surgery and can be received by those with high surgical risk and elderly people.
Short hospital stay is also beneficial for the patients who underwent TAVI.
Our hospital has many options, and we provide treatment with a heart team that transcends the boundaries between surgery and internal medicine so that we can propose the optimal treatment for each patient.
Tobu Hospital, we established the "Heart Team" and
it started at the end of 2012.
The treatment method of the department to which the doctor in charge belongs
Instead of prioritizing, crossing the boundaries of department
Doctors and staff talk with each other
Suitable for each patient
We propose the optimal treatment method.
The Heart Team will continue to support you after treatment.
Yasunori Iida, Director of Cardiovascular Surgery
Surgery is the standard treatment for aortic stenosis. However and the elderly, who cardiac function is impaired, such as those where there is a previous heart surgery history, carried out under cardiac arrest using an artificial heart-lung surgery for a patient's surgery is a high risk, in our hospital in February 2014, we started treatment for TAVI (transcatheter aortic valve placement: TAVI).
In our hospital, physician, Surgery physician, Anesthesiology physician, Clinical Engineer, Registered Nurse, depth under consultation by the heart team, including, it is while safely noted this treatment. Surgery hospitalization period is shorter than that of surgery, and we aim to treat high-risk patients without degrading their quality of life. I hope that even elderly people who do not give up treatment will come to hear the story.
Cardiovascular anesthesiologist Yohei Akiyama
TAVI is less burdensome to the patient's body than regular thoracotomy and causes less pain after surgery. However, TAVI is basically surgery since it is a procedure that is difficult patients surgery is the object, or an advanced age, and or have other illnesses, often there is a risk to enforce the general anesthesia is. In addition, delicate systemic management by Anesthesiology is required to respond to the patient's ever-changing condition during surgery. Our hospital is a cardiovascular anesthesia accredited facility and has abundant experience in TAVI. Please feel free to receive treatment at our hospital.
Cardiac Lehabilitation Tea
m
Supports much better social rehabilitation than before TAVI
It is not uncommon for some patients to become physically weak due to illness or to have a poor quality of life due to mental depression. Our cardiac rehabilitation is a comprehensive program based on the concept of "rehabilitation", in which we work with patients to think about goals and support them in achieving them.
Our cardiac rehabilitation team provides guidance for physical function evaluation before surgery and smooth rehabilitation after surgery, provides exercise therapy according to the patient after surgery, and counseling to eliminate various anxieties. , We will give guidance to prevent recurrence. By doing so, we will help patients to lead a more energetic daily life than before surgery and return to social life.
Tobu Hospital, and we are in close cooperation with our hospital, which we are participating in. We also share timely exchanges of content that is difficult to understand in writing, such as by telephone.
In aortic stenosis, already in the elderly patients that have come up with symptoms such as palpitations and shortness of breath, Surgery in the surgery there is a case of a large physical strength burden. TAVI is a very effective treatment in such cases. The patients at our hospital actually received TAVI, but they are doing well, and we are grateful for the generous follow-up after surgery at the Tobu Hospital
Valvular disease surgery with the introduction of TAVI
Even those who have given up can be treated
The possibility has increased.
Tobu Hospital, no reservation is required and anyone can
We have established a "valvular disease outpatient clinic" where you can receive medical examinations.
For those who are suffering from valvular disease and its treatment
Please feel free to contact us.
Even if you can't come on Wednesday or Thursday
We accept the first consultation every weekday (reception 8:30-11:00).
045-576-3000(Representative)
Reception hours 9:00-17:00 (Saturdays, Sundays, and holidays)
Please tell us "To the outpatient department of the Cardiovascular Center".
