Caseous calcification of mitral annulus is a rare disease characterized by tumors of the mitral cusps. Operative case reports, however, are rare because this lesion seldom negatively affects hemodynamics. We encountered a 67-year-old female case of mitral regurgitation with caseous calcification of mitral posterior annulus due to ischemic heart disease and performed mitral valve replacement and CABG. The excision of the mitral thickened lesion resulted in a defect of the mitral annulus, which needed to be repaired with an autologous pericardial patch. We mainly report the intraoperative findings of this case.

The U-40 generation of surgeons are practicing through trial and error, and form various careers. At the 51st Annual Meeting of the Japanese Society of Cardiovascular Surgery, U-40 Special Project, we looked back on the U-40 generation and more senior doctors to see what kind of future visions, problems and careers they have had. We conducted a questionnaire for the purpose of visualizing the future prospects of the U-40 generation. In this article, we report the results.

In the U-40 column, we conducted a questionnaire survey of the U-40 generation on the theme of the specialist system for cardiovascular surgery and reported on the present condition and problems in obtaining certification. With the introduction of a new system, off the job training and participatory training using extracorporeal circulation techniques were newly mandated. In this article, we report the results and discussion of the questionnaire survey regarding the present condition of extracorporeal circulation training for the U-40 generation and the pros and cons of training programs.

The importance of off the job training in surgical education are widely recognized. The Japanese Board of Cardiovascular Surgery has required a board candidate to do at least 30 hours of off the job training from 2017. U-40 Basic Lecture Course are held annually for young cardiovascular surgeon to learn about basic surgical skills. U-40 Advanced Lecture Course was started to provide opportunity to have more advanced hands-on lecture for young cardiovascular surgeon. However, after the COVID-19 pandemic, the opportunity to hold hands-on seminars are highly limited. In such circumstances, we held a hybrid hands-on seminar. We report details about the hybrid hands-on seminar.

We investigated how cardiovascular surgeons get a day off.