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Updates on JAYCS activities and
Idiosyncrasies of Japanese cardiac surgery
13th Annual Scientific Meeting for ISMICS, 16 – 19 June , 2010, Berlin, Germany
International Fellows Session
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,
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
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
The goals of JAYCS
Regulations of JAYCS; Oct. 28, 2008
Executives of JAYCS
1
2345
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. 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)
Membership
Individual Member : young cardiac surgeons ≦ postgraduate year 15 advisors > postgraduate year 16
Total number of JAYCS members
222
Members
Start:Oct 282008
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
Associate professor Lecturer Lecturer
Assistant professor
Assistant professor
Assistant professor
Assistant professor
Staff Staff Staff Staff Staff
graduate student
graduate student
graduate student
graduate student
Dept. of Cardiac surgery
“A” University program “B” Medical school program
resident resident resident resident
medical student
Chief professorAssociate professor Lecturer Lecturer
Assistant professor
Assistant professor
Assistant professor
Assistant professor
Staff Staff Staff Staff Staff
graduate student
graduate student
graduate student
graduate student
Dept. of Cardiac surgery
resident resident resident resident
medical student
Programs
director
director
director
director
Associate professor
Chief professor
practice, research, education
Postgraduate year
Years
MembersSpecialty
99
33
48
JAYCS individual members ( 15yrs)≦
JAYCS activities
1. Annual Seminar
2. Biannual symposium
3. Frequent informal meetings
Routine Activities of JAYCS
• 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!
• 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.
Comments
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
Risk-adjusted Mortality, Items equivalent to STS Database
Since 1999
・ 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%
J Thorac Cardiovasc Surg 2004;127:1151-7
Ann Thorac Surg 2004;78:1304 –11
・ A new device must be introduced over a long time
It takes much time to be approved by The Ministry of Health, Labor and Welfare
For example,
Commercially available Stent –Graft
1998 Europe
2000 USA
2007 Japan
TAG: Gore & Associates, Inc.
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
30-day mortality 0.2%
RVOTR (337 cases, Neonate 5, Infant 105, 1-17 years 227):
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 NetworkWJTTN
East Japan Tissue Transplant NetworkEJTTN
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 NetworkWJTTN
East Japan Tissue Transplant NetworkEJTTN
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 do our Best for our Patients.
Let’s Challenge Together !!!Let’s Challenge Together !!!
Thank you for your attention!
Danke schon!..