In serious heart failure, where heart function no longer improves despite the utmost in medical and surgical efforts, the Left Ventricle Assist System (LVAS) and a heart transplant are the two main options for treatment. However, currently the LVAS is used only as a bridge-to-transplant, and because of the shortage of heart donors, only a limited number of transplants can be performed. For this reason, treatment of heart failure using an autologous skeletal myoblast sheet has brought attention to cardiovascular surgery as a possible third method of treatment. Use of the layered myoblast sheet in cardiovascular surgery was developed collaboratively by Dr. Yoshiki Sawa, Professor at our university, and Dr. Teruo Okano, Professor at Tokyo Women’s Medical University.
Skeletal myoblasts taken from the femoral region of the patient are cultured to form a sheet.This skeletal myoblast sheet transplantation method is called cytokine therapy and is intended to induce regeneration of cardiac muscle to restore cardiac function. This regeneration of cardiac muscle is stimulated by cytokines released from the skeletal myoblast sheet. This therapy is on the leading edge of clinical research. In 2007, Dr. Sawa and his group were the first surgeons in the world to apply this therapy to an LVAS-implanted patient with dilated cardiomyopathy, and they succeeded in restoring good cardiac function and later removing the LVAS. Even after three years of therapy, no decrease in cardiac function of the patient has been observed.
Although this therapy is still in clinical trials, a total of 16 patients have received it thus far. Four of the 16 patients were LVAS-implanted patients, and in 2 of the 4 patients, the LVAS was successfully removed. In the 12 patients without LVAS implants, effects of the therapy were evident in 10 patients. There was no transplant rejection response because the patient’s own cells were used, and applying the sheet to the heart makes the therapy more reliable compared to the conventional method of injecting myoblast cells with a syringe. There is less stress on the patient, and safety problems such as arrhythmogenicity have not been observed. With this therapy, it is possible for LVAS-implanted patients to have the LVAS removed, as well as for patients, including adults over 60, to experience recovery of cardiac function when a heart transplant was initially considered a risk. Therefore, this therapy is considered a promising development in the field of myocardial regeneration.
Our hospital has played a leading role for many years in the field of cardiovascular surgery in Japan. Because of our efforts, we have been able to improve performance results and develop new surgical procedures and therapies, which is the reason that our performance record in open heart surgery ranks among the highest in Japan. At the same time, we have been performing minimally invasive cardiac surgery (MICS), in which the surgical wound is kept under 10 cm in length. Nearly 90% of coronary artery bypass grafting performed at our hospital is off-pump coronary artery bypass grafting. With this kind of surgical technique, early recovery and early hospital discharge can be achieved. In treating valvular disease, we consider valvuloplasty, which allows us to preserve the patient’s own valve, to be our first choice.
|Ischemic Heart Disease||105 cases|
|Valvular Disease||129 cases|
|Thoracic Great Vessels||187 cases|
|Abdominal Great Vessels||127 cases|
|Congenital Cardiac Disease||86 cases|
|Heart Transplant||8 cases|
|Left Ventricular Assist Device (LVAS)||28 cases|
|(Operative Mortality Rate 0.27%)|
Another characteristic of our hospital is comprehensive therapy. This therapy consists of three essential procedures: heart transplants, artificial hearts, and regenerative medicine. We provide these procedures for patients with serious heart failure who cannot be saved by conventional procedures. We are the first surgeons in Japan to succeed in a heart transplant and a simultaneous heart and lung transplant. Over 100 patients have received LVAS implants at our hospital, and we have been actively accepting patients from overseas, including Saudi Arabia, to provide myocardial regeneration therapy using myoblast sheets. In order to provide patient-friendly therapy in cardiovascular surgery, we have taken the initiative in promoting the establishment of a system for surgical treatment of serious heart failure ahead of other nations by utilizing state-of-the-art technologies, including regenerative medicine.
Here at our hospital, it is our number one mission to overcome serious heart failure by applying therapies for intractable cardiovascular disease. We aim to make a global contribution in the medical field, and we have already begun accepting patients from overseas. Patients can receive myocardial regeneration therapy using myoblast sheets as well as other therapies. If you have serious heart failure with no therapeutic choice in your home country and have some potential for recovery of cardiac function (myocardial viability), please contact us for a consultation.
Dr. Yoshiki Sawa
Dr. Yoshiki Sawa is Professor in the Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine.
He earned a medical degree from Osaka University Faculty of Medicine in 1980 and joined the First Department of Surgery, Osaka University School of Medicine.
In 1989 he pursued further education in both the departments of cardiovascular physiology and cardiac surgery at the Max-Planck Institute in Germany.
After returning to Japan, he became an assistant surgeon in the First Department of Surgery, Osaka University School of Medicine.
He also served as a senior member of the medical staff and then a lecturer before he became an assistant professor in 2002.
In 2006, he became Professor and Dean of the Department of Cardiovascular Surgery at the Osaka University Graduate School of Medicine.
He became Director of the Center for Advanced Medical Engineering and Informatics of Osaka University in 2010, Vice Chair of the Medical Innovation Promotion Office, Cabinet Secretariat in 2011, and Assistant Director of Osaka University Hospital and Director of the Medical Center for Translational Research in 2012.
Various data will be sent to us and a review will take place for assessment. Once your admission to our hospital is determined, various tests will be performed after your arrival in Japan and hospitalization.
|Harvesting muscle tissue from femoral region of inferior limb||Myoblasts being cultured at the Cell Culture Center||Fabricating myoblast sheets on thermoresponsive cell culture dishes and multi-layering into 3 to 4 sheets|
|Transplanting the myoblast sheets onto the surface of the heart|
(The First Department of Surgery, the predecessor of the current department,
was founded in 1922. )
Ischemic Heart Disease (Coronary Artery Disease), Valvular Disease of the Heart, Aortic Disease in Thoracic and Abdominal Regions, Peripheral Vascular Disease, Congenital Heart Disease of Children and Adults
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2-15 Yamadaoka, Suita-shi, Osaka 565-0871
|A short walk from the Osaka Monorail Handai-byoin-mae Station
15 minutes from Senri-chuo Station by car
35 minutes from the Shinkansen Shin-Osaka Station by car
|30 minutes from Osaka International Airport
(Itami Airport ) by car
90 minutes from Kansai International Airport by car