Mitsuhiro Kawata, MD, PhD,
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Mitsuhiro Kawata, MD, PhD, . Shin Takabayashi, MD, PhD,. Hiroo Takayama, MD,. Yasutaka Hirata, MD, PhD, . Kazuma Okamoto, MD, . Hiroyuki Tsukui, MD, PhD, . Naoto Miyagi, MD, PhD, . 13 th Annual Scientific Meeting for ISMICS, 16 – 19 June , 2010, Berlin, Germany.

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Updates on JAYCS activities and Idiosyncrasies of Japanese cardiac surgery

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Mitsuhiro Kawata, MD, PhD,

Shin Takabayashi, MD, PhD,

Hiroo Takayama, MD,

Yasutaka Hirata, MD, PhD,

Kazuma Okamoto, MD,

Hiroyuki Tsukui, MD, PhD,

Naoto Miyagi, MD, PhD,

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


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

1

2

3

4

5


Individual Member :

young cardiac surgeons ≦ postgraduate year 15

advisors > postgraduate year 16

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)


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

practice, research, education

“A” University program

“B” Medical school program

director

director

Dept. of Cardiac surgery

director

Dept. of Cardiac surgery

Chief professor

director

Chief professor

Associate

professor

Associate

professor

Associate

professor

Lecturer

Lecturer

Lecturer

Lecturer

Assistant

professor

Assistant

professor

Assistant

professor

Assistant

professor

Assistant

professor

Assistant

professor

Assistant

professor

Assistant

professor

Staff

Staff

Staff

Staff

Staff

Staff

Staff

Staff

Staff

Staff

graduate

student

graduate

student

graduate

student

graduate

student

graduate

student

graduate

student

graduate

student

graduate

student

resident

resident

resident

resident

resident

resident

resident

resident

medical student

medical student


Postgraduate year

JAYCS individual members (≦15yrs)

Specialty

Members

48

99

33

Years


JAYCS activities


Routine Activities of JAYCS

  • Annual Seminar

  • 2. Biannual symposium

  • 3. Frequent informal meetings

4. ISMICS International Fellows Session


  • JAYCS homepage: 33000 hits

  • Provide information about

  • International fellowship

  • Meetings and seminars

  • Review of textbooks

  • 2009 Chief surgeon questionnaire

  • 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

JAYCS

Search

Click!


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

  • Europe

  • 2000 USA

  • 2007 Japan

TAG: Gore & Associates, Inc.

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!


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