Mitral Valve and Left Atrial Myxoma Operation Using a Combined Superior Transseptal Approach / 日本心臓血管外科学会雑誌

The combined superior transsseptal approach (CSTA) has been used for 12 mitral or left atrial myxoma operations. This approach provided excellent exposure of the mitral valve or myxoma. This approach was compared with the transseptal and left atrial approaches in 1 and 3 cases, respectively. There were no differences in operative time, cardiopulmonary bypass time, anoxic time, bleeding volume, blood transfusion volume and postoperative arrhythmic complications. We use CSTA for cases with tricuspid valve disease, small left atrium, reoperation and left atrial myxomas.

Two Cases of Granulocytosis Treated Successfully with Recombinant Granulocyte Colony Stimulating Factor(G-CSF) after Cardiac Surgery / 日本心臓血管外科学会雑誌

Two cases of granulocytosis after cardiac surgery were treated successfully with a recombinant granulocyte colony stimulating factor (rhG-CSF). Case 1 was a 65-year old man who underwent a double valve replacement due to infective endocarditis. As his white blood cell counts decreased to 1, 000/mm³ on the 24th postoperative day due to long-term antibiotic therapy, 125μg of rhG-CSF was given intracutaneously for 7 days. White blood cell counts increased after the 27th postoperative day and reached 15, 500/mm³ on the 30th postoperative day. The patient became afebrile immediately after administration of rhG-CSF. Case 2 was a 70-year-old man who suffered pneumonia after aortocoronary bypass surgery. As his white blood ceell counts decreased to 2, 300/mm³ on the 21st postoperative day, 80μg of rhG-CSF was given intracutaneously for 7 days. He became afebrile after the 22nd postoperative day and his white blood cell counts increased 18, 200/mm³ on the 28th postoperative day. rhG-CSF not only increases white blood cell counts but also reduces infectious symptoms and therefore is effective in managing granulocytosis after cardiac surgery.