ABSTRACT
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.
ABSTRACT
We studied the effects of the electrolyte composition (K, Ca, Na) and prostaglandin E<sub>1</sub> of the extra-cellular fluid on the tension development of isolated canine coronary arterial strips. In 20mEq/<i>l</i> potassium solution, 4.7mEq/<i>l</i> calcium produced coronary artery contraction. This Ca-induced contraction was partially inhibited dose-dependently (between 10<sup>-15</sup>M and 10<sup>-12</sup>M) by prostaglandin E<sub>1</sub>. Above 10<sup>-11</sup>M, intensity of the inhibition did not change. In the presence of 20mEq/<i>l</i> potassium, the reduction of sodium concentration to 12mEq/<i>l</i> increased the tension of coronary artery. Prostaglandin E<sub>1</sub> did not affect this tension development. After 5min perfusion of prostaglandin E<sub>1</sub>, Ca-induced contraction was not inhibited. It is concluded that low calcium, high sodium cardioplegic solution may relax the canine coronary artery. Addition of prostaglandin E<sub>1</sub> to cardioplegic solution may reduce the coronary artery contraction partially.