Innovative Approaches in Cardiac Surgery
The Journey and Achievements of Dr. Kang Joonkyu, a Pioneer in Hybrid Cardiac Surgery
- Master Doctor
- Hybrid Cardiac Surgery
- Kang Joonkyu
- Heart Surgery Center
- Coronary Artery Disease
이원국 기자
“A physician renowned for exceptional healing.” This is the literal definition of a 'Master Doctor.' The criteria for a master doctor may evolve with time and circumstance. Today, it includes not only clinical experience and skill but also those who transform the world into a healthier place through diverse activities such as volunteer work, research, and entrepreneurship. While university hospitals focus on severe diseases and high-difficulty treatments, primary and secondary hospitals serve as the first gateway to maintaining everyday health.
Accordingly, K-Health has launched a new column, ‘The Doctor: Master’s Report.’ Our goal is to introduce master doctors across university, primary, and secondary hospitals who have silently dedicated themselves to their specialties based on ▲expertise in their field ▲evidence-based clinical principles ▲patient communication and community contribution, as well as those who demonstrate a principled medical philosophy through various activities beyond the examination room.
Our second featured expert is Kang Joon-kyu, Director of the Heart Surgery Center (Professor, Department of Thoracic and Cardiovascular Surgery) at The Catholic University of Korea Eunpyeong St. Mary’s Hospital. <Editor’s Note>
The career of Kang Joonkyu, Director of the Heart Surgery Center, has moved in a single direction: the "Heart." After graduating from Ajou University School of Medicine, he completed his Master’s and Ph.D. at the same institution.
His clinical path began in 2004 as a Clinical Instructor in the Department of Thoracic and Cardiovascular Surgery at Asan Medical Center. He then served as a Full-time Instructor at Inje University Sanggye Paik Hospital before joining the Department of Thoracic and Cardiovascular Surgery at The Catholic University of Korea Seoul St. Mary’s Hospital in 2010.
Now, with 20 years of experience as a thoracic surgeon, he is dedicated to saving patients' lives as the Director of the Heart Surgery Center at Eunpyeong St. Mary’s Hospital.
“I will major in Thoracic and Cardiovascular Surgery.”
The voice of the intern in his twenties, standing there without knowing what lay ahead, was firm. Although that single sentence determined the course of his life, he has never once regretted that choice since.
“During my internship... my father suffered greatly from heart disease. That was when I made up my mind. I decided I would specialize in Thoracic and Cardiovascular Surgery.”
His choice, born from personal experience, eventually expanded into the lives of countless patients.
Kang Joonkyu, Director of the Heart Surgery Center, has established a solid position in the field of cardiac surgery. The Cardiovascular Hospital of The Catholic University of Korea Eunpyeong St. Mary’s Hospital has rapidly built up achievements since its opening in April 2019. Within just one week of opening, the hospital successfully performed a hybrid surgery using Minimally Invasive Direct Coronary Artery Bypass (MIDCAB). Within a year, it achieved 3 heart transplants and 100 cardiac surgeries. This was followed by surpassing 270 arrhythmia procedures, 600 coronary interventions, and 10,000 echocardiograms, finally bearing the valuable fruit of 300 cardiac surgeries in just 3 years and 4 months.
He attributes these achievements not to "speed" but to "structure." Director Kang Joonkyu emphasized, "We have established a detailed medical system centered on the Heart Surgery Center, including the Valve/Imaging Center, Aortic/Peripheral Vascular Center, and Heart Failure Clinic." He added, "When a patient visits the hospital with chest pain, shortness of breath, or palpitations, they can undergo consultations and examinations—and even confirm their results—all on the same day."
Though he spoke calmly, his words carried the true essence of medical care.
“Today, ‘personalized treatment’ is becoming increasingly important across all medical fields. Hybrid cardiac surgery is one of the methods that best aligns with this trend.”
In particular, Director Kang Joonkyu possesses unrivaled expertise in the field of ‘Hybrid Coronary Revascularization (HCR),’ also known as hybrid cardiac surgery. This procedure is performed when two or more of the three coronary arteries that supply oxygen and energy to the heart are narrowed. It combines stent insertion to widen the existing vessels with surgical treatment (Coronary Revascularization), which creates a new pathway using the patient’s own blood vessels.
The coronary arteries, which supply nutrients to the heart, deteriorate due to various factors such as aging, diabetes, and hyperlipidemia. If a stenosis occurs in even one of the three coronary arteries, it leads to a reduction in blood flow to the heart, which can result in myocardial (heart muscle) damage or a heart attack.
The coronary arteries, which supply oxygen and nutrients to the heart, divide into left and right branches and surround the entire heart. Among them, the Left Main Coronary Artery (LMCA) splits into two vessels—the Left Anterior Descending (LAD) artery and the Left Circumflex (LCX) artery—at a site called the 'ostium of the Left Anterior Descending artery.'
Among these, the Left Anterior Descending (LAD) artery is the most critical vessel. Since this artery is responsible for more than 50% of the heart's blood flow, any blockage poses a significant threat to life. Therefore, definitive treatment through surgery is the safest approach.
Typically, by using the Left Internal Mammary Artery (LIMA) to connect directly to the LAD, the patency rate remains over 95% even after 10 years. In contrast, for the right coronary artery (PDA) or the lateral artery (OM), stent procedures alone can yield sufficiently good results. These vessels show a maintenance rate of approximately 80 to 90% over a 10-year period, regardless of whether a stent or surgery is performed.
In essence, hybrid cardiac surgery involves treating the most critical vessel through "surgery" and the remaining vessels through "intervention (stenting)." This treatment approach maximizes both the stability of surgical procedures and the convenience of minimally invasive interventions.
Director Kang Joonkyu emphasized, "Hybrid procedures can be applied to patients with stenosis in two or more of the three coronary arteries, or to those at high risk of surgical complications." He added, "In particular, since it is performed with minimal incisions, the burden on patients is significantly reduced."
An elderly male patient (aged 89) visited Eunpyeong St. Mary’s Hospital complaining of squeezing chest pain. He was diagnosed with "coronary artery disease." The problem was that many parts of his coronary arteries were severely hardened due to calcification, making stent insertion difficult. Furthermore, his advanced age and underlying diabetes made open-heart surgery a significant burden.
Options were few, and time was running out. Director Kang Joonkyu meticulously reviewed the patient’s conditions one by one: multiple coronary artery lesions, diabetes, and advanced age. After weighing all these variables, he arrived at a single solution: ‘Hybrid Surgery.’
Immediate consultation took place. The departments of Thoracic and Cardiovascular Surgery and Cardiology moved in sync to establish a treatment plan without delay. Finally, it was decided to perform a ‘One-Day Hybrid Surgery,’ implementing both stent insertion and coronary revascularization within a single day. Five days later, the patient walked out of the hospital on his own. This was a precious achievement brought about by years of accumulated experience and swift clinical judgment.
Director Kang Joonkyu expressed his expectations, stating, "While hybrid cardiac surgery is a relatively recently introduced treatment method, domestic and international research shows that it yields results comparable to, and in some cases, even better than traditional surgery." He added, "In a super-aged society, hybrid treatment is expected to play an increasingly vital role."
He is also the face of Eunpyeong St. Mary’s Hospital. Upon entering the hospital, the first thing that catches one's eye is his face displayed prominently in the center of a large wall. Although he carries the title of 'promotional ambassador,' that word alone feels insufficient to describe him. What strikes you first, even before his face, are his arms.
“I exercise”
he replied briefly. Director Kang Joonkyu spends more than 100 days a year at the hospital. Yet, he finds time to climb mountains. Currently serving as the president of the Eunpyeong St. Mary’s Hospital Hiking Club, he stays active more consistently than anyone else. Surgery is ultimately a battle of concentration, and concentration stems from physical endurance. He knows this truth through experience.
His future goal is simple: to protect the lives of his patients through the most appropriate surgical methods and to remain responsible for their well-being even after the procedure.
As the interview was nearing its end, a short beep rang out. It was an emergency. Without a word or a second of hesitation, he stood up and headed out.
1. Lifestyle Modification : One must practice basic health guidelines, such as a low-sodium diet, smoking cessation, and weight management, to prevent recurrence.
2. Do Not Take Supplements or Medication Without Consultation : Taking unprescribed medications or health functional foods under the pretext of 'vascular health' can instead lead to serious side effects.
3. Exercise 'Moderately,' Not 'Excessively' : For patients with a history of coronary artery disease, overexertion can be dangerous. Exercise intensity must be adjusted through consultation with your primary physician.
※What is the Cardiac Surgery Center at Eunpyeong St. Mary’s Hospital?
The Cardiac Surgery Center at The Catholic University of Korea Eunpyeong St. Mary’s Hospital features a well-established system of organic collaboration between the departments of Cardiology and Thoracic and Cardiovascular Surgery. In particular, the center has focused on building a medical system where internal medicine and surgery constantly communicate and cooperate—from the initial pre-operative treatment planning stage to post-operative patient care and long-term follow-up observations. Additionally, by opening specialized centers and detailed sub-clinics, the hospital has established a "One-stop System" where patients visiting for chest pain, dyspnea (shortness of breath), or palpitations can receive medical consultation, undergo examinations, and check their results all on the same day.
