Safety of Minimally Invasive Cardiac Surgery in Japan

Abstract

Minimally invasive cardiac surgery (MICS) is rapidly gaining popularity in Japan, and its safety is attracting public attention. The Japanese Society for Minimally Invasive Cardiac Surgery (J-MICS) surveyed myocardial protection during MICS. Among the 97 institutions, blood CP is used in 60, crystalloid CP in 21, and a mixture in 16. Six percent of institutions using blood CP (other than del Nido CP) and 44% of those using crystalloid CP have CP administration intervals of 30 min or longer. De-airing of the aortic root to prevent air embolization into the coronary arteries is routinely performed at 94% of institutions during CP administration and 72% of institutions during water injection tests after mitral valve repair. According to the Japanese Cardiovascular Surgery Database (JCVSD), MICS requires longer aortic cross-clamp time than median sternotomy, but the incidence of postoperative complications, including perioperative myocardial infarction, was similar. J-MICS starts the MICS registry in 2024, and we plan to conduct a detailed analysis of the MICS-specific complications. With our certification and proctorship programs, J-MICS will continue promoting MICS safely in Japan.