J.Jpn. Surg. Soc.. 109(6): 323-328, 2008

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Feature topic

COMPARISON OF THERAPEUTIC STRATEGIES FOR CARDIOVASCULAR DISEASE BETWEEN WESTERN COUNTRIES AND JAPAN

A comparative review was performed to clarify the differences in therapeutic strategies and operative results in cardiovascular disease between Western countries and Japan, with the following results. 1) The operative results in the USA among patients with common cardiovascular diseases were almost the same as among those in Japan, except among those who underwent thoracic descending aortic and thoracoabdominal aortic repair. 2) The number of off-pump coronary artery bypass grafts performed comprises 20%　to 30%　of all coronary revascularization procedures in Western countries, while in Japan the number exceeds 60%. 3) Total endoscopic coronary artery bypass grafting and percutaneous aortic valve implantation can be performed safely but are currently restricted to only a few indications and are associated with several problems that require further improvement. However, these procedures clearly have the potential for extended indications and improved operative results. In these areas, Western countries are ahead of Japan. 4) Selective cerebral perfusion is a safer method of cerebral protection during aortic arch repair compared with retrograde cerebral perfusion and hypothermic circulatory arrest. Many Japanese cardiovascular surgeons have contributed greatly to advances in this method.

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