For over 20 years, our department has been conducting technical support and educational activities in various Asian countries as part of our social contribution efforts.

To resume activities that were temporarily suspended during the COVID-19 pandemic, we visited Hanoi, Vietnam to hold discussions for our next project.

These international exchanges not only help local patients receive better treatment but also have great significance for the education and exchange of young doctors.

We hope that those aspiring to become cardiovascular surgeons will also participate in these activities.

Dr. Kotani from our department visited Vietnam National Children's Hospital again to provide guidance on minimally invasive surgery, which he had taught there four years ago and has now reached 700 cases.

700 Children with Congenital Heart Disease Cured by Minimally Invasive Surgery

At Vietnam National Children's Hospital, a 10-month-old infant weighing only 5.5kg with Tetralogy of Fallot became the 700th patient to receive minimally invasive heart surgery with a small incision under the right armpit.

On August 7, the 6-hour surgery was performed by Dr. Nguyen Le Tin Truong, Director of the Pediatric Heart Disease Center at National Children's Hospital, and Dr. Yasuhiro Kotani, Associate Professor of Cardiovascular Surgery at Okayama University Hospital. Dr. Kotani is the person who introduced this technique to Vietnam five years ago.

Since the introduction of minimally invasive heart surgery technique from the armpit five years ago, 700 surgeries have been performed with a 100% success rate, and no child has experienced serious complications or death. Among the patients who have received this treatment, the youngest was only 1.5 months old and the lightest weighed only 3.8kg.

Dr. Truong says that the doctors at the Heart Disease Center are very interested in this new incision method and special surgical techniques.

Before 2018, median sternotomy was the only method for surgery on children with congenital heart disease. This left large scars on the chest wall, required long postoperative periods, and patients suffered from postoperative pain.

According to Dr. Truong, doctors have improved the surgical technique to reduce the burden on patients. The incision, which was previously about 6cm, has now been reduced to 4cm. This has shortened recovery time and mechanical ventilation time, and also helped reduce postoperative pain.

For teenage patients in particular, the small incision under the right armpit not only allows them to return to normal life immediately, but also has excellent cosmetic benefits as the scar is completely hidden under the right armpit, giving them confidence in themselves.

To date, this method has been applied mainly to relatively simple diseases such as ventricular septal defect, atrial septal defect, partial atrioventricular septal defect, anomalous pulmonary venous return, pulmonary valve stenosis or supravalvular aortic stenosis, left atrial myxoma, and cor triatriatum. Doctors must carefully consider whether each case is suitable for this approach.

Project Manager: Associate Professor Yasuhiro Kotani, Department of Cardiovascular Surgery, Okayama University

In Vietnam, approximately 10,000 babies are born with congenital heart disease each year, but only about 40% of them can receive surgery. To contribute to improving this situation, the Department of Cardiovascular Surgery at Okayama University Hospital has started a JICA grassroots technical cooperation project (cardiovascular disease field) by accepting medical personnel from National Children's Hospital Hanoi and E Hospital in Hanoi, and University Medical Center in Ho Chi Minh City, conducting training in cardiovascular surgery, cardiology, anesthesiology, and nursing. (As of June 2020, 11 teams have completed the program).

We also dispatch doctors and nurses from Okayama University Hospital to provide lectures for local medical personnel.

By having medical personnel who have completed this training provide technical guidance at their own hospitals and surrounding hospitals (*), we aim to establish an independent human resource development system and improve the survival rate of congenital heart disease patients in Vietnam.

* Each hospital provides outreach medical care and medical technology guidance to 5-6 hospitals in the surrounding area.

As part of the JICA grassroots technical cooperation project (cardiovascular disease field) for medical technology support to Vietnam that our department has been implementing since 2016, we accepted one cardiovascular surgeon from National Children's Hospital Hanoi from February to May 2020 and conducted a 3-month training program.

During the training, participants learned surgical techniques and perioperative patient management methods through observation of pediatric congenital heart disease surgeries and visits to wards and intensive care units. After returning to their home country, they will share the knowledge gained during training with local medical personnel to improve the survival rate of patients in Vietnam and provide better medical care.

As part of the JICA grassroots technical cooperation project (cardiovascular disease field) for medical technology support to Vietnam that our department has been implementing since 2016, we conducted training for a total of 15 people in 2019: 6 from National Children's Hospital Hanoi, 5 from University Medical Center HCMC, and 4 from E Hospital Hanoi, providing approximately 4-6 weeks of training in cardiovascular surgery, cardiology, anesthesiology, and nursing.

This activity has also been registered as an "SDGs Achievement Initiative Case Study" at Okayama University.

As part of the JICA grassroots technical cooperation project (cardiovascular disease field) for medical technology support to Vietnam that our department has been implementing since 2016, we provide lectures in pediatric cardiovascular surgery, cardiology, anesthesiology, and nursing at hospitals in Hanoi and Ho Chi Minh City, Vietnam.

In 2019, we conducted lectures for 4 days at National Children's Hospital Hanoi, 2 days at E Hospital Hanoi, and 4 days at University Medical Center in Ho Chi Minh City.

On October 17, 2019, Professor Shingo Kasahara from our department gave a special lecture at the 52nd anniversary ceremony of E Hospital Hanoi.

The Department of Cardiovascular Surgery at Okayama University Graduate School, together with Yamamoto Sewing Factory (Sakaide City, Kagawa Prefecture) and Medilink (Toyota City, Aichi Prefecture), has developed a fabric belt "Calpod Belt" that can be worn all day to continuously measure medical electrocardiograms.

This belt is made by sewing stainless steel wires that serve as electrodes into a fabric belt, which is worn on the human chest to transmit biological data to a server.

In addition to electrocardiogram measurement, this medical device supports physician diagnosis by providing information such as heart rate, exercise intensity, and body temperature. Sales began from Yamamoto Sewing Factory in May.

During the development process, verification tests for stable data collection in daily life and clinical application research were conducted at the Okayama University Advanced Medical and Nursing Equipment Research Promotion Course (concurrently established with the Department of Cardiovascular Surgery), with Professor Kasahara and Research Associate Sakano in charge.

This belt was also introduced in the Nikkan Kogyo Shimbun (May 9, 2019) and Shikoku Shimbun (May 25, 2019).

The Department of Cardiovascular Surgery at Okayama University Hospital has been implementing a JICA grassroots technical cooperation project for medical technology support (cardiovascular disease field) since 2016, regularly accepting medical personnel training teams from hospitals in Hanoi and Ho Chi Minh City, Vietnam, and providing guidance in cardiovascular surgery, cardiology, anesthesiology, and nursing.

In 2018, we conducted approximately 6-week training for a total of 12 people: 6 from University Medical Center in Ho Chi Minh City and 6 from E Hospital Hanoi.