[Postoperative chylothorax treated with fibrin glue and absorbent mesh: a case report].

A 66-year-old man was treated by graft replacement for a thoracic aortic aneurysm. Chylothorax occurred on postoperative day 2. In spite of cessation of oral intake and IVH management, chest tube drainage did not decrease, the patient became malnourished.

[Atraumatic local interruption technique for coronary circulation in MIDCAB].

Various methods have been employed for "local" interruption of the coronary blood flow before anastomosis during MIDCAB. However, coronary artery injury caused by a snare and coronary artery stenosis at the snare site resulting in late complications have been reported. We utilize a technique that minimizes the risk of injury to the coronary artery.

[Size estimation method for patch used in reconstruction of LV cavity].

The reconstruction of LV cavity is accomplished by suturing a patch to the viable myocardium to exclude the infarcted area from the high LV pressures. However, there is no clear guideline to estimate the size of patch used for LV reconstruction. We have designed a new method to determine the correct patch size, and applied it in 5 cases.

[A clinical experience of agranulocytosis just after open heart surgery].

A 63-year-old woman who underwent aortic and mitral valve replacement developed agranulocytosis just after operation. It was considered that agranulocytosis was caused by bone marrow suppression by antiarrhythmic agent and extracorporeal circulation. Her white blood cell counts decreased to 300/mm3 on the third postoperative day, but increased surprisingly 5 days after administration of G-CSF.

[A successful surgical treatment of postinfarction posterior ventricular septal defect through a right ventricular approach].

A 72-year-old man with acute postinfarction ventricular septal defect located posteriorly underwent successful operation through a right ventricular approach. Following cardiac catheterization revealed posterior ventricular septal defect with 82% left to right shunt ratio and coronary angiography showed three vessel disease, emergency operation was performed. The defect was exposed through anterior right ventriculotomy and closed by a teflon patch sutured right side of the interventricular septum, with added bypass grafting to left anterior descending artery.