The oldest patient at Kitano Hospital, a 92-year-old man, underwent valve replacement surgery (valve replacement) for severe heart valve disease on March 27, 2013. He experienced no postoperative complications, actively participated in rehabilitation, and was discharged safely and in good health on April 20.

Although this patient was generally in good health, he was over 90 years old, and all of us at the Heart Center discussed very carefully whether or not to perform surgery.

He was admitted to the hospital in February 2012 due to heart failure, and although his condition improved with medical treatment, he required treatment for severe valvular disease (the difference in pressure between the left ventricle and aorta, an indicator of severity, was 150mmHg; normally there is no difference). At this point, we considered catheter-assisted valve replacement surgery (known as TAVI or TAVR), which is said to be gentler on the body than the usual open-chest cardiac surgery using an artificial heart. Only four facilities in Japan are currently permitted to perform this procedure, and we requested treatment from one of them. After further consideration, we found that his heart shape was unsuitable for catheter-assisted surgery, and we were forced to abandon the plan.

After that, the patient was given oral medication, including diuretics, at our hospital's cardiac center outpatient clinic, but the heart failure was difficult to control, so we again discussed open-chest heart surgery with the patient and his family. The patient, who was in good health, resolutely replied, "I'm a little scared, but I'll do my best and undergo the surgery." We medical staff were encouraged by these powerful words and did our best to treat him.

I believe the patient's positive attitude contributed to this positive outcome.

We are extremely grateful to all the cardiac center staff involved in the treatment.

Kitano Hospital, Cardiac Center, Chief of Cardiovascular Surgery
Koji Ueyama