J.Jpn. Surg. Soc.. 113(3): 273-277, 2012

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Feature topic

DOES JAPANESE CORONARY ARTERY BYPASS GRAFTING QUALIFY AS A GLOBAL LEADER?

Since the introduction of coronary artery bypass graft (CABG) surgery, Japanese cardiothoracic surgeons have made significant contributions to the continuing evolution of the procedure, particularly to progress in arterial conduits. In 1988, Kitamura et al. described the internal thoracic artery (ITA) as a "live" conduit for pediatric patients requiring CABG. Since then, the physiological and clinical characteristics of the ITA graft have been investigated and reported by numerous Japanese surgeons. Since the development of the use of the right gastroepiploic artery as a graft by Suma, Japanese surgeons have contributed significantly to its clinical usage worldwide. In the 21st century, energetic Japanese surgeons have been making every effort to improve their surgical outcomes by performing off-pump CABG. While only 15% of surgeons in Europe and North America use the off-pump technique, more than 60% of surgeons in Japan do so. Despite a much smaller surgical volume, Japanese surgeons have achieved comparable outcomes to those abroad. This also is attributable to the medical insurance system in Japan. In conclusion, CABG in Japan now qualifies as a global leader.

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