Development of Innovative Surgical Treatment from Okayama University

<p>I became a professor and chairman at the department of cardiovascular surgical unit of Okayama University in 1993, two years after I was back from a consultant cardiac surgeon at Royal Children’s Hospital, Melbourne. Before I started a new program at Okayama University, University Hospital had been doing less than 5 pediatric surgical cases a year. Now, we perform 300–400 pediatric cardiac surgeries per year and has become one of the leading pediatric cardiac surgery hospitals in the world. Since 1993, we have done more than 8,000 pediatric cardiac surgeries with a mortality of around 1％ and published more than 300 papers in English. These achievements are contributed to by the influence of my mentors in New Zealand and Australia: Sir Brian Barratt-Boyes at Green Lane Hospital, NZ, who developed homografts and profound hypothermia and circulatory arrest and Roger Mee at the Royal Children’s Hospital, Melbourne, who developed techniques including the trapdoor technique in arterial switch operations, double switch operation for patients with cc-TGA, and the Mee technique for intramural coronary arteries. I have been greatly influenced by these two legends. In 1998, we developed a new surgical technique, the so-called Sano shunt (RV-PA shunt), as the first stage palliation for hypoplastic left heart syndrome (HLHS). Other new procedures include RV/RA exclusion to treat severe forms of Ebstein’s anomaly in 1996, staged biventricular repair of pulmonary atresia and intact ventricular septum in 2001, and cerebral perfusion during aortic arch repair in 1996. More recently we started to research progenitor cell therapy for single ventricle patients with heart failure, which went to Phase I clinical trial in patients with HLHS in 2011. This was the first successful clinical trial of cardiac progenitor cell therapy in a pediatric population. We have now finished Phase I and II, and began Phase III (a multi-center study) in August 2016. My mentors always told me to be an academic and innovative surgeon and this is what I want to share with the next generation.</p>