Valvular Heart Disease Treatment Center
As a top runner in minimally invasive treatment
We offer the best treatment for each patient.
Palpitations, shortness of breath, easy to get tired etc...
Consult the Valvular Heart Disease Treatment Center before the subjective symptoms of valvular heart disease become stronger.
Valvular heart disease is a condition in which some of the four valves in the heart are damaged and cannot perform their intended function. When the valve is damaged, the heart cannot pump enough blood throughout the body, leading to heart failure. The main symptoms are "shortness of breath", "palpitations", "chest pain", "dullness", and "swelling". Some people have few subjective symptoms and are diagnosed with heart murmurs and abnormal electrocardiograms caused by auscultation at the time of health checkup.
Valvular Heart Disease Treatment Center first conducts outpatient examinations on such patients to diagnose the degree of heart failure and the presence or absence of valvular disease. If the valvular disease is detected, we will select and explain the treatment method that suits the patient from (1) drug adjustment, (2) catheter treatment, and (3) heart surgery. Our hospital not only has a wide range of treatment options for valvular heart disease, but also supports a wide range of people with disease such as diabetes and cancer by taking advantage of the general hospital.
Transcatheter aortic valve implantation
TAVI is an abbreviation for Transcatheter Aortic Valve Implantation and is a treatment for severe aortic valve stenosis. A catheter is inserted into the blood vessel from the femoral artery, subclavian artery, or apex, the folded prosthetic valve is carried to the heart, and the prosthetic valve is placed in the aortic valve. Immediately after replace, the TAVI valve functions as a patient's valve. This hospital is one of the TAVR specialized facilities (38 facilities nationwide, as of August 2021) by the Japan Society for Transcatheter Heart Valve Treatment (JTVT).
For elderly people with less physical burden
Less burden on the patient's body, different from conventional surgery that it is used a cardiopulmonary equipment,
The effectiveness of TAVI has been proven
Large-scale clinical studies have been conducted on the clinical results of TAVI in various countries and regions, and good long-term results have been obtained in terms of efficacy, safety, and improvement of quality of life. TAVI has been performed well compared to surgical valve replacement.
Patients who applicable to TAVI
This is an example for you to imagine the image of an adaptive patient, not a case of a real patient.
Case-1 78 year old male
- Occupation
- Retired. Hobby is playing with grandchildren
- Medical condition
- Angina (history of bypass surgery), diabetes, hypertension
A man who has had bypass surgery for angina more than 10 years ago and is out of the hospital with diabetes and hypertension. Recently, he said that he was short of breath while playing with his grandchildren and couldn't keep up with him. An outpatient examination revealed severe aortic stenosis. I am worried about my second time of heart surgery and am hoping for catheter treatment.
Case-2 88 year old female
- Occupation
- housewife
- Medical condition
- Angina
I am going to the hospital because of high blood pressure. You say that you have recently become very short of breath and have had a sensation of tightening your chest after moving. Outpatient echocardiography revealed severe aortic stenosis, and CT showed stenosis in the coronary arteries.
Case-3 81 year old male
- Occupation
- Retired. Taking a walk with a dog is a daily routine
- Medical condition
- Severe aortic stenosis, scheduled for Orthopedic Surgery
I had shortness of breath while taking a walk for several years, but I thought it was because of my age. This time, before an orthopedic surgery, I diagnosed with severe aortic stenosis because of decreased cardiac function.
Percutaneous mitral valve insufficiency repair system
This is an treatment option to severe mitral valve regurgitation. A clip on the tip of the catheter fastens the mitral valve leaflet to reduce regurgitation and improve mitral regurgitation. MitraClip is also well adaptive for patients who had worsen heart function and did not gain benefit from surgery.
Less invasive, Faster recovery, Shorter hospital stay
MitraClip inserts a catheter through the femoral vein, which is easy to stop bleeding, so there are no cuts left and there are few complications of bleeding.
Effective for functional mitral regurgitation associated with heart failure
Functional mitral regurgitation (FMR) may be present in patients with heart failure who have poor cardiac function and who are repeatedly hospitalized and discharged due to poor symptoms. MitraClip has been shown in clinical trials to improve life prognosis and quality of life in such patients compared to drug therapy.
Patients who applicable to edge-to-edge repair: MitraClip
This is an example for you to imagine the image of an adaptive patient, not a case of a real patient.
Case-1 73 year old male
- Occupation
- Retired people. Gateball is a hobby.
- Medical condition
- Chronic heart failure
He suffered from myocardial infarction at the age of 65 and has a history of coronary artery bypass surgery. After that, I was taking medicine for chronic heart failure and chronic kidney disease. Shortness of breath appeared in the gateball for several years, and an echocardiography showed that left ventricular function was extremely reduced to LVEF 35%, and functional mitral regurgitation (FMR) was diagnosed as severe.
Case-2 77 year old male
- Occupation
- Retired people. Taking a walk is a daily routine
- Medical condition
- Chronic heart failure
A man who takes a walk on a daily routine. As a chronic heart failure, I received a pacemaker therapy, ventricular resynchronization therapy (CRTD) several years ago. Recently, shortness of breath has become stronger again, so when an outpatient echocardiography was performed, the left ventricular function was extremely reduced to 24%, and functional mitral regurgitation (FMR) was also severe.
Case-3 87 year old female
- Occupation
- Housewife
- Medical condition
- Chronic heart failure
Recently, I went to the hospital because my shortness of breath became severe during housework and be at stairs, and my legs were swollen. Upon undergoing echocardiography, she was diagnosed with organic mitral regurgitation (DMR) and was admitted to the hospital because of pleural effusion on a chest X-ray. As I am old and my legs are weakening recently, I am worried about heart surgery, and if possible, I would like to receive catheter treatment.
Left atrial appendage closure
Atrial fibrillation is a major cause of stroke causing a blood clot in a pocket called the left atrial appendage located in front of the left atrium. Until now, anticoagulant therapy (warfarin or direct anticoagulant DOAC) was the only treatment to prevent this. However, the problem was that there could be cause other side effects such as bleeding. Percutaneous left atrial appendage occlusion system reimbursed in Japan from September 2019 to achieve this problem: WATCHMAN physically lid on the left atrial appendage and prevents stroke even if anticoagulant therapy is quit. It is an epochal device that can be done.
Those who are having trouble with bleeding while taking anticoagulant for atrial fibrillation
Those who want to discontinue anticoagulants due to repeated melena, nasal bleeding, bloody urine, subcutaneous bleeding, gastric ulcer or diverticulum bleeding, hospitalization history of cerebral bleeding, bleeding due to fall, etc. In contrast, WATCHMAN is a one-time, minimally invasive treatment that can simultaneously reduce the risk of bleeding from long-term anticoagulant administration and the risk of stroke due to anticoagulant discontinuation.
Treatment results of over 50,000 cases worldwide
WATCHMAはワーファリンと比較し、大きな出血性合併症を72％、後遺症を伴ったり致死的な脳卒中を55%、全死亡率を27% 減少させることが臨床研究で分かっています。一方、手技による安全性（合併症発生率は1.5%程度）も報告されています。
Patients who applicable to Left Atrial Appendage Closure
This is an example for you to imagine the image of an adaptive patient, not a case of a real patient.
Case-1 68 year old female
- Occupation
- Retired people, volunteers
- Medical condition
- Hypertension, gastrointestinal bleeding
I am taking warfarin 5 mg, but I have experienced severe gastrointestinal bleeding due to anticoagulant therapy in the past, and I am still suffering from bleeding.
Case-2 80 year old male
- Occupation
- Grandfather who often takes care of his grandchildren
- Medical condition
- Congestive heart failure, hypertension, diabetes
Currently, he is taking the anticoagulant rivaroxaban 15 mg / day. If you have a history of hip fracture and cerebral contusion due to a fall. The attending physician believes that there is an increased risk of secondary major bleeding due to trauma.
Case-3 72 year old female
- Occupation
- Retired, flying around
- Medical condition
- Hypertension, PCI history (stent placement)
He has a history of PCI due to coronary artery disease in the past and has been stent deployment, so she is currently taking two antiplatelet drugs. Therefore, the attending physician considers that the risk of bleeding is high when used in combination with anticoagulants.
Introduction of outpatient doctor
Doctor info.
Director of Cardiovascular Surgery
Iida YasushiIsao Yasunori Iida
- Outpatient day
- Tuesday 8: 30-11: 00
I, as a member of the Heart team Cardiology physician, Anesthesiology physician, Clinical Engineer, operating room performs the staff and the conference, "unreasonable, uneven, waste" is not, the treatment "fell to Fu" patients We will formulate a treatment strategy that will allow you to receive it.
I always try to treat patients as "family". If you think about it for your family, I believe that you can demonstrate high performance without neglecting daily efforts and study.
In recent years, Surgery has increased the chances of seeing older and more vulnerable patients. Tobu Hospital have many options, not just one treatment. We will continue to do our utmost to treat patients as a team.
- Board specialist / certified doctor
- Doctor of Medicine
- 3 Society Cardiovascular Surgery Certified Organization Cardiovascular Surgery Specialist / Training Instructor
- Japan Surgery Society Certified Physician / Specialist / Instructor
- Japanese Angiology Specialist
- Japanese Society of Surgery
- Superficial femoral artery stent graft practitioner
- Chest / abdomen stent graft instructor
- Visiting Lecturer, Keio University School of Medicine
- Transcatheter aortic valve replacement (TAVI) SAPIEN series practitioner
Chief Cardiology
Kohei Yamaguchi
- Outpatient day
- Monday 8:30 to 11:00
- Board specialist / certified doctor
- Japanese Circulation Society Cardiologist
- Certified Internal Medicine Doctor from the Japan Society of Internal Medicine
- Cardiovascular Catheterization Certified Doctor of the Japanese Society of Cardiovascular Intervention and Therapy
- Japanese Society of Transcatheter Heart Valve Therapy Japanese Transcatheter Aortic Valve Implantation (TAVI) Supervisor SAPIEN Series CoreValve Series
- Japan ACLS Association ACLS, BLS provider
Cardiology physician
Yusuke Setonaga
- Outpatient day
- Thursday 8: 30-11: 00
- Board specialist / certified doctor
- Internal Medicine Specialist
- Cardiovascular Catheterization Certified Doctor of the Japanese Society of Cardiovascular Intervention and Therapy
- JB-POT Japanese Perioperative Transesophageal Echocardiography Certification Committee Japanese Perioperative Transesophageal Echocardiography (JB-POT) certified physician
