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KMID : 0371319690110010001
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Journal of the Korean Surgical Society
1969 Volume.11 No. 1 p.1 ~ p.10
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Total Heart Valve Replacement Surgeries and a New Hingeless Valve
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Wada, Juro
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Abstract
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An nyong ha ship nikka!
Professor Chin, Professor Lee, distinguished surgeons of Korea and members of the Korean Surgical Society, distinguished guests and ladies and gentlemen.
For the first, may I express my gratitude for the privillege of honor given to me today to tell you something about my work done at northernmost Japan.
And this opportunity orginated from the date in autumn last year, when Professor Chin came to International College of Surgeons Meeting in Gifu. He told me, "You Dr. Wada look like a good friend of Korea. Why don´t you try to come and visit Seoul?" Well, I have never been to your country, Korea, in my life.
As soon as I got an invitation from Professor Chin, I hurried back to my little sweatheart, who is sitting here, my only girl, (laughs) and we discussed the invitation. She said, "Yes, you should go, because Professor Chin is such a big surgeon. If you say no, you´ll lose a good friend in Asia, and in a professional way too."
So I followed the adivice of my sweatheart and the day before yesterday, I came to your country on a beautiful day, but discouragingly the weather changed to rainy and stormy yesterday. But always one thing has two aspects, sunny side and rainy side, surface and back. Strong and weak, and big and small! I think this is a special treat of your country to let us experience a warm beautiful Korea the day before yesterday, and raining stormy weather yesterday and today intermediate(laughs).
Could you show the first slide.
As you know, development of the practical oxygenator, as shown here called as Sapporo Disposable, all in one, Oxygenator, makes us able to treat many cardiac diseases under direct vision.
(Slides)
Well, this is a disposable oxygenator we have developed.
And no blood is needed for priming. To set up the oxygenator, it takes only three or five minutes.
And with the advent or use of an oxygenator like this, we can treat many kinds of intracarcondition was poor and the prospect was very grim. The parents urged me to do the best in my power.
And I replied that I would do so. We quickly set up our heart-lung machine with disposable oxygen-exchange bag and his femoral artery was canulated for retrograde perfusion of 100% oxygented arterial blood as assisted circulation.
But is was apparent that the patient now turned into a vegitable existence. I went to the family again and told them that their boy was dying.
Then, the idea of transplanting this men´s heart to the another poor patient with hopeles situation of trivalvular disease. Soon the E.E.G. and E.C.G. tracing showed that the patient had expired. With condolence to the family I conveyed the idea of transplanting their boy´s heart to this 17 years old boy so that their son´s heart would function for another person´s life.
The parents not only agreed on but also wished all the best luck to the recepient boy.
In the middle of the night, it was. But everybody was on hand even though they had not been called. We were ready for any action. The heart-lung machine on this dead body was continued inorder to perfuse the heart in situ. The operation of transplanting heart was carried out. Next slide.
See the giant size of the heart with trivalvular disease exposed to the surgical field. Next slide.
The diseased heart has been removed and the huge pericardial sac is in view. Next Slide.
Now the new heart is put in and it is functioning normally. Notice the disproportionate size of the pericardial sac and the newly transplanted heart. Next slide.
Little over a month after surgery, the patient who received a new heart is eating a good meal. Next slide.
And, trying to find the news on the paper when Dr. Wada is going to visit Korea.(laughs)
He is enjoying his happy life as a man of age 18,78th day today in Sapporo, Japan. Light, please.
Well, in short, prosthetic valve has contributed in the line of helping patient´s suffering from valvular diseases. Is ultimate goal prosthetic valve or biological valve? I do not know. Probley biological valve and improved prosthetic valve will exist just like both sides of a knife. Both will be studied and utilized usefully in treating valvular diseases.
If the valves are affected, more than three, or the myocardium is badly damaged by coronary occlusion beyond the treatment of any surgical intervention, or not surgically treatable, amendable malformation is present, surgenous will step on the shoulder of the experience, replacement of part of the heart and go to the total heart replacement.
It is a gratifying experience to see this young boy who once was nearly dying hopeless patient, now with happiness in his face and cheerful brightness in his eyes. And I think, replacement surgery in heart, at least, which started from replacement of valves and arrived to a total heart replacement, has now opened a new era in surgical field.
The medical or surgical treatment until today has been focused to repair the organ, reconstruct or revitalize the organ. If the organ itself is beyond the help of reconstruction or revitalization, that means that death is to come.
But the idea of transplanting new organ can open up a new field of treating patients who are left beyond the reach of currently available medical treatment.
What are the diseases that can be helped with transplantations? There are many.
Diabetes beyond control of medical treatment, for instance, can be helped by pancreas replacement to a new life.
The new era is to come and it is here.
I am telling this story not to you but to myself.
I thank you very much for the honor given to me to be with you today. Thank you very much.
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