13th Annual Scientific Meeting for ISMICS, 16 – 19 June , 2010, Berlin, Germany
International Fellows Session
Updates on JAYCS activities
and
Idiosyncrasies of Japanese cardiac surgery
Mitsuhiro Kawata, MD, PhD, Shin Takabayashi, MD, PhD,
Yasutaka Hirata, MD, PhD, Kazuma Okamoto, MD,
Naoto Miyagi, MD, PhD,
Hiroo Takayama, MD,
Hiroyuki Tsukui, MD, PhD,
Updates on JAYCS activities
Objectives of JAYCS
Easy to understand,
Our policy is…
JAYCS
of the young cardiac surgeon,
by the young cardiac surgeon,
for the young cardiac surgeon.
Gettysburg Address by U.S. President Abraham Lincoln
The goals of JAYCS
1. Improve the skills and knowledge of young cardiac surgeons
2. Improve the communication and exchange of information among young
cardiac surgeons
3. Enhance the communication between young cardiac surgeons and
established surgeons through lectures and teachings
4. Establish mutual respect between young cardiac surgeons and established
surgeons
5. Contribute to the improvement of cardiac surgery patient care
6. Obtain global perspective of our specialty
Regulations of JAYCS; Oct. 28, 2008
Executives of JAYCS
1. One Representative Director
Shin Takabayashi
2. Two Accounting Auditors
Hiroo Takayama
Naoto Miyagi
3. Up to 15 Directors from nationwide (5 regions)
4. Two Consultants
Shinichi Takamoto: President of the JSCVS
Shunji Sano: Professor of Okayama University
4
5
3
1
2
Membership
1. Cardiac surgeons (Individual Member)
2. Cardiac surgery programs (Institutional Member)
3. Medical companies that endorse the objectives of JAYCS (Supporting Member)
4. Others, such as med. students/nurses… (Homepage Member)
Individual Member :
young cardiac surgeons ≦ postgraduate year 15
advisors > postgraduate year 16
Total number of JAYCS members
Members
222
Start:
Oct 28
2008
Structure of JAYCS
Total: 222 members
Work in 136 hospitals including 25 abroad
Graduated from 56 medical schools
Belong to 43 programs
Individual: 180
not belong to programs:31(17%)
Adviser: 26
Homepage: 13
Institutional: 3
Programs
“A” University program
practice, research, education
“B” Medical school program
director
director
Dept. of Cardiac surgery
director
Chief professor
Associate
professor
Assistant
professor
Staff
Lecturer
Assistant
professor
Staff
graduate
student
resident
Staff
graduate
student
resident
Chief professor
Associate
professor
Lecturer
Assistant
professor
Staff
Assistant
professor
graduate
student
medical student
Associate
professor
Assistant
professor
Staff
Staff
resident
Dept. of Cardiac surgery
director
graduate
student
resident
graduate
student
resident
Lecturer
Assistant
professor
Staff
graduate
student
resident
Lecturer
Assistant
professor
Staff
Staff
Assistant
professor
Staff
graduate
student
graduate
student
resident
resident
medical student
JAYCS individual members (≦15yrs)
Members
Postgraduate year
Specialty
48
99
33
Years
JAYCS activities
Routine Activities of JAYCS
1. Annual Seminar
2. Biannual symposium
3. Frequent informal meetings
• JAYCS homepage: 33000 hits
Provide information about
International fellowship
Meetings and seminars
Review of textbooks
2009 Chief surgeon questionnaire
JAYCS
• Ongoing Projects
1. JAYCS textbook of the cardiac surgery
2. Discussion Forum in JAYCS homepage
3. Cannulation technique hands-on seminar
4. Globalization of cardiac surgery
5. 2010 Young surgeon questionnaire
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Comments
• We have waited for a suitable opportunity.
Now, our main interest is to improve Japanese
training system for young cardiac surgeons.
• To create better future of cardiac surgery,
we have to
“Reconstruct the training system in Japan”.
• At first, to make many people pay attention to the
issue, JAYCS will pull a trigger on the meetings in
this summer and winter.
How to create a nationwide program regulation system?
Cardiac surgery in Japan
1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese
cardiac surgeons
1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese
cardiac surgeons
Japan Adult Cardiovascular Surgery Database
Since 1999
Risk-adjusted Mortality,
Items equivalent to STS Database
・Good outcome of Aortic surgery
4707 records were analyzed from 97 hospitals
(between January 1, 2000, and December 31, 2005).
Raw 30-day and 30-day operative mortality rates were
6.7% and 8.6%, respectively.
Conclusion:
,,,,,,,,the result of this series was excellent.
(Circulation. 2008;118[suppl 1]:S153–S159.)
European Journal of Cardio-thoracic Surgery 36 (2009) 517—523
・Good outcome of Off-pump CABG
Gen Thorac Cardiovasc Surg (2009) 57:488–513
OPCAB (10,979 cases):
•63.4% of the total isolated CABG(17,295 cases)
•Primary elective, 30-day mortality 0.7%
•Primary emergency, 30-day mortality 4.1%
•Redo, emergency, 30-day mortality 4.8%
Ann Thorac Surg 2004;78:1304 –11
J Thorac Cardiovasc Surg 2004;127:1151-7
・A new device must be introduced over a long time
For example,
Commercially available Stent –Graft
1998 Europe
2000 USA
TAG: Gore & Associates, Inc.
2007 Japan
It takes much time to be approved
by The Ministry of Health, Labor and Welfare
1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese
cardiac surgeons
・Good outcome of RVOT reconstruction / repair
with ePTFE conduit
with monocuspid patch
Gen Thorac Cardiovasc Surg (2009) 57:488–513
RVOTR (337 cases, Neonate 5, Infant 105, 1-17 years 227):
30-day mortality 0.2%
Ann Thorac Surg 2000;70:1511– 4
no perioperative death
good motion of all cusps
no or trivial pulmonary regurgitation
J Thorac Cardiovasc Surg 2007;134:327-32
*no mortality, no morbidity
*no patients required reoperation during follow-up.
*Valve motion was fully maintained in all patients.
1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese
cardiac surgeons
Homograft is difficult to obtain.
Japanese Society of Tissue Transplantation
since 2001.10.27
West Japan
Tissue Transplant Network
WJTTN
East Japan
Tissue Transplant Network
EJTTN
Cardiac valve
and vascular bank
Cardiac valve
and vascular bank
Pancreatic islet bank
Pancreatic islet bank
Bone bank
Bone bank
Skin bank
Japanese Society of Tissue Transplantation
since 2001.10.27
West Japan
Tissue Transplant Network
WJTTN
East Japan
Tissue Transplant Network
EJTTN
Cardiac valve
and vascular bank
Cardiac valve
and vascular bank
Pancreatic islet bank
Pancreatic islet bank
Bone bank
Bone bank
Skin bank
donor
recipient
donor recipient
Postoperative care in ICU or CCU is
mainly the task of cardiac surgeons.
Intensivists for post cardiac surgery are
definitely rare.
Advantage?
Disadvantage?
Let’s do our Best for our Patients.
Let’s Challenge Together !!!
Thank you for your attention!
..
Danke schon!