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National Cerebral and Cardiovascular Center Hospital (Update: September 1, 2014)

Brain and heart: of all the organs in the human body, these two are among the most critical in sustaining life. Since they are connected to each other via blood vessels, if either malfunctions the other is automatically affected. Researching the brain, heart, and vessels as a whole will lead to new treatments for both cerebral and cardiovascular disorders.

With this perspective, the National Cerebral and Cardiovascular Center (NCVC) in Osaka, Japan, consists of the Research Institute and Hospital. They jointly conduct research and provide treatment for cerebral and cardiovascular disease. Since its foundation in 1977, the NCVC has been designated as an advanced national medical research center, also known as a “national center”, with the mission of “sustaining the health of the Japanese people with the cooperation of the national health policy.” Even worldwide, it is a unique feature of the NCVC that the hospital and research units are fully integrated and jointly conduct comprehensive research in cerebral and cardiovascular medicine. Today, the Hospital is a national and global leader in this field.(see also National Cerebral & Cardiovascular Center | NCVC

As the medical treatment section of the Center, NCVC Hospital offers the newest facilities and is equipped with the most advanced technology. What is more, NCVC Hospital is among the leading institutions in Japan in terms of safely performing high volumes of highly advanced operations such as heart transplantation and ventricular assist device implantation. In fact, 3500 thoracic aorta operations and more than 2500 abdominal aorta operations have been performed at the Hospital since it was established, a record that is outstanding even from a global point of view. Furthermore, the Hospital has been an opinion leader in pediatric cardiology as well as cerebral and cardiovascular disorders of the mother and fetus.

NCVC Hospital has promoted the use of advanced facilities for emergency medical care since soon after its founding, and it has become a leader in this area. For example, a coronary care unit (CCU) was established 30 years ago for management of hyperacute myocardial infarction, and today it is one of the oldest such units in Japan. This CCU has been the source of significant knowledge and skill. In fact, the mortality rate at NCVC Hospital due to myocardial infarction has been less than 10% for the last 20 years.

Since the approval of intravenous thrombolysis (intravenous t-PA) for acute strokes in Japan in 2005, NCVC Hospital has developed team-based treatment approaches for these patients and has sought to unify emergency procedures. The Hospital now performs an average of four such treatments per month in a safe and secure manner. As of August 2012, around seven years after t-PA approval, the Hospital had administered intravenous t-PA to 325 patients and achieved among the best results nationwide, with nearly half of these patients showing no physical impediments three months after treatment. These outcomes compare favorably with those in Europe, where 39% of patients are completely autonomous after three months (0 or 1 on the modified Rankin Scale), and are better than the outcomes in the SITS-Monitoring Study (SITS-MOST).

Furthermore, the Hospital is developing prevention and treatment models of lifestyle-related diseases and chronic diseases.

In addition to each clinical department, specialists at the National Cerebral and Cardiovascular Center Research Institute and medical support staff are involved in the treatment of patients.

About the Hospital

Established in 

1977

 

Location

5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.

 

Clinical Departments

Department Division Diseases
Department of Cardiovascular Medicine Division of Coronary Disease Ischemic heart disease (angina, acute myocardial disease), etc
Division of Vascular Disease Aortic disease, arteriosclerosis obliterans, thromboangiitis obliterans (Buerger’s disease), etc
Division of Heart Failure Heart failure, dilated cardiomyopathy, hypertrophic cardiomyopathy, valvular heart disease, secondary cardiomyopathy, pericardial disease, etc
Division of Arrhythmia Pulmonary arterial hypertension, pulmonary venous hypertension, Acute pulmonary thromboembolism, chronic pulmonary thromboembolism, etc
Division of Pulmonary Circulation Sick sinus syndrome, atrioventricular block, Extrasystole, atrial fibrillation and flutter, paroxysmal supraventricular tachycardia, long QT syndrome, Brugada syndrome, ventricular tachycardia, ventricular fibrillation, etc
Department of Cardiovascular Surgery Division of Adult Cardiac Surgery Ischemic heart disease (angina, acute myocardial disease), valvular heart disease, arrhythmia, chronic heart failure, etc
Division of Vascular Surgery Aortic root dilation; thoracic, thoracoabdominal, and abdominal aortic aneurysm; acute and chronic aortic dissection; pulmonary thromboembolism; arteriosclerosis obliterans
Department of Stroke and Cerebrovascular Diseases Division of Cerebrovascular Medicine and Neurology Cerebral apoplexy (cerebral infarction and cerebral hemorrhage), transient ischemic attacks, asymptomatic cerebrovascular diseases, asymptomatic carotid artery stenosis, etc
Division of Neurosurgery Ruptured aneurysm, unruptured aneurysm, cerebral arteriovenous malformation, hypertensive intracerebral hemorrhage, acute subdural hematoma, brain tumor, etc
Department of Cerebrovascular Medicine and Neurology Division of Pediatric Cardiology Congenital heart disease, arrhythmia, pulmonary hypertension, Kawasaki disease, cardiomyopathy, cardiac tumor, endocarditis, myocarditis, chronic heart failure, etc
Division of Pediatric Cardiovascular Surgery Atrial septal defect, ventricular septal defect, tetralogy of Fallot, tricuspid atresia, Kawasaki disease, cardiomyopathy, infective endocarditis, etcAtrial septal defect, ventricular septal defect, tetralogy of Fallot, tricuspid atresia, Kawasaki disease, cardiomyopathy, infective endocarditis, etc
Division of Maternal Fetal Medicine and Gynecology Pregnancy with heart disease, pregnancy with cerebral hemorrhage or infarction, pregnancy-induced hypertension, fetal heart rate abnormality, fetal heart disease, etc
Department of Lifestyle-related Disease Division of Hypertension and Nephrology Hypertension (including secondary hypertension), hypotension, kidney diseases (chronic kidney disease, renal failure, diabetic nephropathy), etc
Division of Endocrinology and Metabolism Diabetes, dyslipidemia, obesity, metabolic syndrome, etc
Division of Preventive Cardiology Medical examination specific to cardiology, medical examination for the elderly, health guidance, smoking cessation treatment, prevention of circulatory diseases, etc
Division of Transplantation Dilated cardiomyopathy, dilated phase of hypertrophic cardiomyopathy, ischemic heart disease, fulminant myocarditis, care after heart transplantation

 

Number of beds

Section Number of Beds Remarks
General Ward 514  
Intensive Care Unit 40 Intensive care unit for the cardiovascular surgery (ICU) 16
    Coronary Care Unit  (CCU) 8
    Stroke Care Unit  (SCU) 6
    Neurosurgical Care Unit (NCU) 4
    Pediatric Intensive Care Unit (PICU) 6
Neonatal Intensive Care Unit 6 NICU  
High Care Unit 16 HCU  
Children’s Ward 36    
Total 612    

Total floor area
97,179㎡

Total site area
77,617㎡

 

Main medical devices

Hybrid operating room system

System Purpose Room

Cardio- and cerebrovascular radiography system for a hybrid operating room
● AlluraXper FD 20 (for a hybrid operating room) (Manufactured by Philips)
● Magnus operating room
(Manufactured by Maquet) 
● Ceiling supply unit
(Manufactured by Maquet)

● Operating light H LED (Manufactured by Maquet)
Aortic stent graft Catheterization room

Summary of the system

A hybrid operating room combines an operation table and a cardio- and cerebrovascular radiography system.
The facility began full-scale operation in 2011 and was the first of its kind in Japan.

In our hybrid operating room,   high-resolution three-dimensional images can be reconstructed and examined immediately using high-resolution radiography. Using this system, we can now rapidly and safely perform high-level and advanced operating techniques such as aortic stent-grafting and transcatheter aortic valve implantation, used for the restoration of blood vessels.

 

Surgical robot system

System Purpose Room
da Vinci S surgical
(Manufactured by Intuitive Surgical Inc, USA)
heart surgery No.5 operating room

Summary of the system

This is a computer-controlled device used to support endoscopic surgery. As the surgery can be performed without median sternotomy, both intraoperative hemorrhage and large postoperative scars can be minimized. Operations can be conducted precisely and safely as three-dimensional images are displayed on a monitor and remotely controlled by a surgeon. As of May 2014, 55 cases have been treated.

 

Gamma knife

System Purpose Room
Gamma knife
(Model)Lexsell gamma unit, type 4C
 (Elekta)
Stereotactic radiotherapy Gamma knife room

Summary of the system

The gamma knife, used in NCVC Hospital since April 2002, is a radiotherapy system that involves convergent irradiation of 201 gamma-ray beams on one point in the brain (the focus). The treatment is so-named because it allows doctors to treat the focus as if it were being cut with a knife, but without the need for craniotomy. There is thus minimal effect on the scalp, bone, cerebral parenchyma, blood vessels, and nerves surrounding the focus.

It has become possible to conduct less stressful treatments of vascular malformations and tumors that are situated deep inside the brain and that would have previously been difficult to treat surgically. This treatment can now be applied to elderly patients or those who cannot tolerate surgery.

 

Angiography system

System Model Purpose Room
Angiography 1 Artis zee dB/C
(Siemens)
Electrophysiology Cardioangiography Catheterization Room 1
Angiography 2 Artis zee dB/C
(Siemens)
Cardiac catheterization Cardioangiography Catheterization Room 2

Summary of the system

This system is used to precisely examine the blood vessels deep in the heart, checking for narrowing or occlusion. The cardiac catheterization rooms at NCVC Hospital have four devices; these are used to obtain fluoroscopic images from two directions. Conditions such as angina, arrhythmia, and congenital heart diseases are diagnosed and treated by medical specialists. In addition, our facility has been recognized for promoting reductions in radiation exposure during angiography and treatment.

Angiography 5 INFX-8000V XTBP-8100G
(Toshiba)
Blood vessels in general Radiography Room 5

Summary of the system

We have two systems dedicated to the examination of cerebral blood vessels, the great vessels (chest and abdominal regions), and peripheral vessels. They can also obtain fluoroscopic images from two directions. The images can be visualized using DA (digital angiography) and DSA (digital subtraction angiography), contributing to the diagnosis and treatment via catheterization. They make it easier to see the blood stream by using angiography and CT data to reconstruct three-dimensional images, for example, thus allowing the catheter to reach the target for treatment.

 

CT

System Model Purpose Room
CT system Aquilion ONE TSX-301A
(Toshiba)
Examination of the head and body parts Radiography Room 7

Summary of the system

Our 320-row CT can obtain images with a 16-cm long region during one rotation, which is about four times larger than those obtained by conventional CT systems. This allows us to dynamically visualize the blood vessels in the head more easily (each image can be obtained in as little as 0.35 seconds). In addition, this system can be used to perform traditional radiography conducted by the blood vessel catheter, for example, in a non-invasive manner. These days, with the introduction of the consecutive approximation and reconstruction system, radiography can be performed with the radiation exposure levels around half of what they were previously.

CT system SOMATOM  Definition Flash
(Siemens)
Examination of body parts Radiography Room 8

Summary of the system

By using two X-ray tubes and detectors simultaneously, Dual Source CT has a time resolution of about twice as high (75 ms) as traditional systems. This feature allows the scanner to better image actual “movement.” It is now possible to perform detailed examinations of the heart in cases of high heart rate or arrhythmia, which previously was not feasible. In addition, as ultra-high-speed double helical radiography using two X-ray tubes is now possible, examinations can be performed with less radiation exposure than traditional systems. Moreover, we hope that these new machines, which scan at two different energies, will contribute to future improvements in our diagnostic abilities.

 

MRI

System Model Purpose Room
MRI system Magnetom Verio 3.0T
 (Siemens)
Whole-body MRI  scanning Radiography Room 1(3T-MR Room)

Summary of the system

This room is equipped with new detectors and workstations for nuclear cardiology. Examinations are performed using up-to-date scintillation cameras manufactured by Philips, which have high capacity, resolution, and efficiency. In particular, automatic heart tracking results in supersensitive and high-resolution images with fewer artifacts. Moreover, the latest software permits high-precision quantitative analysis of cardiac functions.

 

Nuclear medicine scan

System Model Purpose Room
Gamma camera Bright View
(Philips)
SPECT Laboratory Room A

Summary of the system

This room is equipped with new detectors and workstations for nuclear cardiology. Examinations are performed using up-to-date scintillation cameras manufactured by Philips, which have high capacity, resolution, and efficiency. In particular, automatic heart tracking results in supersensitive and high-resolution images with fewer artifacts. Moreover, the latest software permits high-precision quantitative analysis of cardiac functions.

SPECT/CT Symbia T6
(Siemens)
SPECT/CT Laboratory Room C

Summary of the system

The hospital is now equipped with a SPECT system combined with a CT scanner (SPECT/CT) for use in diagnostic nuclear medicine. It is expected that this system will allow us to obtain higher-resolution images and to easily identify abnormal areas in combination of SPECT and CT images. In addition, it is possible to obtain high-precision fusion images by means of detailed superposition and also high-resolution SPECT images by conducting CT-based attenuation correction.

PET/CT Biograph mCT
(Siemens)
PET/CT PET Room A

Summary of the system

PET is an imaging technique specifically designed to observe the functioning of living bodies. It is possible to scan the entire body in a single examination to see whether organs, for example, are working normally.

Since 2000 we have performed PET/CT, which integrates up-to-date PET technology with 40-row multi-detector-row CT. The CT scanner, which can image a large area with high speed and precision, allows us to conduct PET rapidly and to largely mitigate the stress on patients. By combining the functional images obtained by PET with the morphological images obtained by CT, minute lesions can be detected with higher sensitivity. Research is under way to allow us to conduct not only whole-body examinations for malignant tumors, but also measurements of myocardial blood flow reserve, brain circulation and metabolism, useful for more rapidly diagnosing circulatory diseases.
Cyclotron CYCLONE 18/9
(IBM)
RI (Radioisotope) production Cyclotron Room

Summary of the system

PET uses a dedicated camera to capture images of the radiation released by radioactive drugs. One of the features of these drugs is that their half-lives are very short. The drug named FDG (Fludeoxyglucose F 18), used to scan the entire body for malignant tumors, has a half-life of about 2 hours, and there are radioactive drugs with even shorter half-lives, for example about 2 minutes. Such radioactive drugs must be produced inside the hospital, in particular near the PET room. For this purpose, the hospital has two cyclotrons. The radioactive drugs produced using the radionuclides created by the cyclotrons are assayed as hospital preparations by the pharmacists in charge of PET, and are then used for examinations and clinical research that require such radioactive drugs.

 

 

National Cerebral and Cardiovascular Center Hospital
http://www.ncvc.go.jp/english/hospital/