Updates on JAYCS activities

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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
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Updates on JAYCS activities
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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
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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
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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
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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)
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Total number of JAYCS members
Members
222
Start Oct 28 2008
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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
programs31(17) Adviser 26 Homepage 13
Institutional 3
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Programs
practice, research, education
A University program
B Medical school program
director
director
Dept. of Cardiac surgery
director
Dept. of Cardiac surgery
director
Chief professor
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
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Postgraduate year
JAYCS individual members (?15yrs)
Specialty
Members
48
99
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Years
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JAYCS activities
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Routine Activities of JAYCS

• Annual Seminar
• 2. Biannual symposium
• 3. Frequent informal meetings

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• 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
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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?
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Cardiac surgery in Japan
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1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese cardiac
surgeons
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1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese cardiac
surgeons
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Japan Adult Cardiovascular Surgery Database
Since 1999
Risk-adjusted Mortality, Items equivalent to
STS Database
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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. Conclusio
n ,,,,,,,,the result of this series was
excellent. (Circulation. 2008118suppl
1S153S159.)
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European Journal of Cardio-thoracic Surgery 36
(2009) 517523
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Good outcome of Off-pump CABG
Gen Thorac Cardiovasc Surg (2009) 57488513

• 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

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Ann Thorac Surg 2004781304 11
J Thorac Cardiovasc Surg 20041271151-7
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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
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1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese cardiac
surgeons
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Good outcome of RVOT reconstruction / repair
with ePTFE conduit with monocuspid patch
Gen Thorac Cardiovasc Surg (2009) 57488513
RVOTR (337 cases, Neonate 5, Infant 105, 1-17
years 227)
30-day mortality 0.2
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Ann Thorac Surg 2000701511 4
no perioperative death
good motion of all cusps
no or trivial pulmonary regurgitation
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J Thorac Cardiovasc Surg 2007134327-32
no mortality, no morbidity
no patients required reoperation during
follow-up.
Valve motion was fully maintained in all
patients.
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1. Adult cardiac surgery
2. Congenital cardiac surgery
3. For all Japanese cardiac
surgeons
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Homograft is difficult to obtain.
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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
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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
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donor
recipient
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Postoperative care in ICU or CCU is mainly the
task of cardiac surgeons.
Intensivists for post cardiac surgery are
definitely rare.
Advantage?
Disadvantage?
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Lets do our Best for our Patients.
Lets Challenge Together !!!
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Thank you for your attention!
..
Danke schon!