Minimally invasive cardiac surgery in Japan: history and current status

Area of Science:

• Cardiovascular Surgery
• Surgical Innovation
• Healthcare Systems Research

Background:

• Review of English-language reports on Minimally Invasive Cardiac Surgery (MICS) in Japan.
• Historical overview of MICS adoption, enthusiasm, and subsequent decline in Japan.
• Identification of key factors influencing MICS trends over recent decades.

Observation:

• Initial MICS enthusiasm in Japan during the 1990s faced limitations in the early 2000s.
• Recent resurgence driven by specific procedures: minimally invasive mitral valve surgery, aortic valve replacement, atrial septal defect closure, and coronary artery bypass.
• Recognition of the need for structured support for MICS advancement.

Findings:

• Minimally invasive mitral valve surgery, aortic valve replacement, atrial septal defect closure, and coronary artery bypass are key drivers of MICS resurgence.
• Limitations previously hindered widespread MICS adoption.
• Successful MICS programs require robust infrastructure and training.

Implications:

• Academic societies and national registry systems are crucial for safe and effective MICS implementation.
• Off-the-job training and team building are essential components for successful MICS programs.
• Future MICS growth in Japan depends on addressing past limitations and leveraging new procedural successes.