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What it’s like being a mitral valve veterinary surgeon at thirty years old

INSTAGRAM @kmatsuura_from_vcaj_sah   
Dr. Katsuhiro Matsuura graduated from Rakuno Gakuen University (Hokkaido, Japan) in 2013. Katsuhiro found an interest in cardiology in his first year at work. He worked hard on clinical work and research with his love for animals. His efforts contributed to obtaining a PhD, being certified as a board certified member of Japanese veterinary cardiology society, and becoming the youngest mitral valve surgeon with practicable results. For more information about mitral valve surgery or clinical cases, check out his Instagram.

My name is Katsuhiro Matsuura, I am a veterinary cardiology specialist at VCA Japan Shiraishi Animal Hospital in Saitama, Japan. As a child, I loved dogs and dreamed of getting a job which I could help preserve the human-animal bond. The driving force of my pursuits is my love for them. In a way, becoming a veterinarian was a means, not an end.

When I was young, I liked making origami art, which is the art of traditional Japanese paper folding. Japanese children play by making cranes, turtles, ships, and planes from a piece of paper. I was more interested in figuring out how to make cranes, a classic origami design with the smallest piece of paper possible, rather than experimenting with various designs. I quickly realized that in order to do this, I could not use ordinary paper. I had to use a gum wrapper because it is easier to handle. The smallest paper I’d ever folded with my bare hands was 0.6 cm. Looking back, I think doing this may have contributed in my ability to control my fingers in a delicate way.

I believe there is no such thing as studying too much. When I was in vet school, I studied hard so that I wouldn’t contribute to breaking the human-animal bond in the future. Still, I sometimes wonder if I could have done more. When I was a fifth-year student (in a six-year system), I was taught by a well-known Japanese veterinary surgeon named Dr. Kadosawa. He was the first top veterinary surgeon I ever encountered. His sincere attitude towards individual cases was admirable, which had a major impact on how I saw things. Over time, he helped me find a job at a renowned surgical veterinary clinic.

After graduating from veterinary Rakuno Gakuen University in Hokkaido in 2013, I got a job at Shiraishi Animal Hospital, where I have been working since then. The hospital regularly invites specialists to provide us with updated knowledge and demonstrate how they work in veterinary clinics. These veterinarians continue to inspire me. Moreover, Dr. Shiraishi, the director of this hospital, is not only a good surgeon, but he understands and responds to my needs as I continue to progress. In my first year, I struggled with general small animal medicine, but at the same time I was motivated to thoroughly observe my skills to select fields that would be suitable for me in the future. This was especially important when it came to surgery. I did keep in mind “Every Second Matters”, no matter what surgery, including neutering surgery. Fortunately, I recognized that I am dexterous and origami training might have given me this advantage…

After a total of five years of training by two surgeons on mitral valve surgery, from 2014 to 2018, I became part of a great team. This happened when I was 30 years old. From 2019 to 2021, my team’s mitral valve surgery success rate reached more than 95 per cent in advanced stage B2 and stage C, which are the most suitable stages for an operation. The achievements of the two other surgeons and I are the following: Ref1. Dr. Kanno, Ref2. Dr. Mori. Our latest achievement will be published soon: Ref3.  Although the hospital I started working for happened to be specializing in cardiac surgery, none of other young veterinarian shave reached the level where they can operate mitral surgery. When asked what makes me different from others, I would say it is imagination. It is important to see what others are doing and then do it yourself, this is called “mirroring.” It was also important to help my colleagues become familiar with cardiology and anesthesiology, when I created the team. No matter how good a surgeon is, surgery will not be successful without a good anesthesiologist or perfusionist.

Although there is still room for improvement in our performance, we are successful, and I am fortunate enough to be able to manage this surgical team. In addition to helping the animals in front of me, I would like to contribute to support the development of the next generation through the treatises and textbooks that are the result of my academic achievement in the future. My Instagram account @kmatsuura_from_vcaj_sah includes various cases and techniques, which can be viewed by anyone online.

Cardiac surgeons are in a very tough position. During general surgery, the operation itself rarely causes the death of the patient. However, heart surgery has a relatively higher risk of death than others despite, even though it is much safer than it was before. We treat precious lives. The accumulation of experience is essential for improving a surgeon’s ability, which means you must take on all the painful emotions and experiences yourself but we must continue walking while praying for the lost lives.

If you are interested in cardiac surgery, is it enough to be dexterous? The answer is no. Without medical knowledge, general surgical procedures, and close communication with clients and staff, you will have devastating consequences. Understanding the basics of these skills can be obtained while working at any hospital. The success depends on how serious you are to learn them. Also, it’s important to recognize that there must be a large team for open heart surgery. So, you should cherish your colleagues.

Mitral valve disease is a common and often life-threatening heart disease in dogs. Treatment with drugs can help relieve symptoms, but it does not cure the disease. Dr. Kanemoto established the successful surgical treatment, mitral valve plasty, in Japan. If you trace the origin of the procedure currently used in the country, it’s all based on his studies. Mitral valve plasty is one of the hardest surgeries for dogs and veterinary staff, because it requires cardiac arrest with cardiopulmonary bypass. Thus, though there is a great demand all over the world, there is very limited access to this surgery, which is mostly performed in Japan.

Finally, if you are interested in becoming a veterinary cardiac surgeon, it is important to try getting a job at a facility that specializes in cardiac surgery. You should find a good mentor and aim to experience a large number of cases with a highly experienced surgeon. However, this can be difficult as there are a limited number of such facilities. If you have the enthusiasm and capacity, I may be able to travel somewhere else in the world to help you with training.

References

1 Matsuura K, Yamada S, Enokizono M, et al. Effect of Ultrafiltration during Cardiopulmonary Bypass in Dogs Undergoing Mitral Valve Plasty (abstr). J Vet Intern Med 2017;31:1255.

2 Matsuura K, Hasegawa M, Shiraishi K, et al. Mitral annular dynamics short term after mitral valve surgery, in Proceedings. 6th Asian Meet of Anim Med Special 2019; p243.

3 Matsuura K, Yoshida T, Uehara T, et al. Metabolic alkalosis following mitral valvuloplasty in a dog with preoperative acute kidney injury. JAVMA, In Press.

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