Toshinobu Kazui

Biography

 

Biography

Cardiac surgery is the most fascinating field in medicine for me. Learning and experiencing cardiac surgery is a never ending endeavor and is always exciting. Cardiac surgical techniques have been evolving continuously. For example, mitral valve repair which preserves LV function and avoids postoperative anticoagulation therapy is more widely used now than in the past. An astonishing evolution can be seen in the devices that support heart function, such as left ventricular assist devices and devices that allow transcatheter aortic valve replacement, TAVR. It is a dynamic field in that the surgical interventions can save sick patients who are in heart failure or have experienced myocardial infarction. Technical progression in current surgical techniques and new types of surgical therapy will continue to be developed, and this lifelong learning process fascinates me.

 

I like the dynamic aspect of cardiac surgery as well as the many opportunities to perform research. Spending a couple of years in clinical and basic research in Japan and the US certainly gave me great training in how to conduct research and write papers. One of my research questions when I was in Japan involved the relationship of the integrity of the mitral valve complex to LV function. I used the speckle tracking method and found that preserving the integrity of the mitral valve complex plays an important role in LV function. My research at Washington University focused on cardiac arrhythmias and function. Currently, I am working on ventricular assisted device related clinical outcome analysis as well as right ventricular functional evaluation to achieve better outcome. My teaching experience in Japan as an assistant professor showed me that teaching can enhance your own understanding and help you to develop good questions to pursue in research. 

 

I have been taught by many surgeons in Japan as well as in the United States. There is a clear difference between Japanese and US training methods. Japanese training is more focused on total management of the patients, including preoperative evaluation, surgical treatment, and postoperative patient care. I learned that each patient needs individualized specific management, because each patient has different risk factors and history. Spending about 8 years in this training in Japan helped me progress significantly in the care of cardiac patients. At the end of my training in Japan, I felt training in the top institutions in the world would be next step for me to progress further. Fortunately, I was privileged to work in the research laboratory of Dr. Ralph Damiano at Washington University in St. Louis for 2 years and do additional clinical training under Dr. Scott Silvestry at Washington University in St. Louis/Barnes-Jewish hospital for an additional year. Training in US is more hands on regarding surgical techniques than in Japan, and allows active involvement with patient management. Also in the US, treatment of patients is shared with Intensivists and PAs.  I am making progress in terms of surgical skills and intraoperative judgement with Dr. Lick's mentorship. My goal is to develop unique skill set in surgical technique as well as total patient management based on my unique training background, and to educate and train next generation in the future. 

 

My father was an excellent cardiac surgeon who performed many aortic repairs and extensive associated research. He successfully established a selective cerebral perfusion method during aortic arch surgery based not only on his surgical experience but also from his basic research.  His method of evolving surgical treatment of cardiac surgery is an ideal for me and he was my first role model as a cardiac surgeon. 

 

My long-term goal is to build a strong clinical practice as well as research which allows me to manage and plan the entirety of patient care and surgery in an excellent manner. I am also interested in leading teaching and clinical research similar to that in which I have been engaged. In addition personally I would like to be an academic surgeon who can operate, educate young surgeons, and perform research in both the laboratory and clinical settings.

 

Cardiac surgery is an exciting field. I would like to buid a program that offers the opportunity to train in a well structured and well administered environment with physicians who love to teach. As I seek to become a skillful clinician, an advocate for my profession, and a committed educator,  I would like to be a part of a program that will make it possible to unite both my personal and professional goals into a single fulfilling career.

Degrees

• Ph.D. Medical Science
• Iwate Medical University, Japan
• Perioperative changes in dynamic aortic root morphology after Yacoub's root remodeling and concomitant aortic annuloplasty
• B.S. medicine
• Sapporo Medical University School of Medicine, Japan
• M.D. medicine
• Sapporo Medical University School of Medicine, Japan