[Japanese congenital heart surgery is almost the same level of Europe and North America].

In the 1990s, the results of congenital cardiac surgery in Japan were inferior to those in Europe and the USA. Many Japanese units were performing only a small number of surgeries, which was one of the reasons for the results. In the 2000s, the results of congenital cardiac surgery in Japan improved dramatically, reaching a level nearly equivalent to that in Europe and the USA. Pediatric cardiac surgical units have become centralized in Japan, and many complex cases are referred to main centers. Data from 2008 clearly show that the results of surgery to treat right heart anomalies such as tetralogy of Fallot and pulmonary atresia are much better in Japan. On the other hand, the circumstances of pediatric cardiac surgeons are far behind those in Europe and the USA, which is a problem to overcome in the future.