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SUMMARY An experimental study was undertaken to evaluate the relative merits of closure of the bronchial stump following lobectomy by means of interrupted silk sutures, Eastman 910 monomer, and Eastman 910 adhesive. Results indicate that suture closure is easier from a technical standpoint and is safer than closure with either the monomer or the adhesive.

THE treatment of traumatic ventricular septal defects produced by penetrating injuries of the heart is a subject of controversy. Some advocate surgical closure of all such defects whereas others su...

Three standard tracheostomy incisions in dogs were compared to determine whether any were more likely associated with stomal stenosis. Each incision resulted in an average reduction in tracheal lumen of 25 per cent, with a 50 per cent maximum. The incision selected should depend on the conditions present.

Cardiac tamponade was diagnosed in 197 patients admitted over 20 years (1955-1974) to the Charity Hospital of New Orleans, for emergency treatment of pentrating mediastinal injuries. Of the 197, 174 definitively treated patients followed one of three patterns of management: 96 had OR thoracotomy, 68% were unstable, and preoperative pericardiocentesis reduced mortality from 25 to 11% (p less than 0.01); 44 had emergency thoracotomy, 91% were unstable, and prethoractomy pericardiocentesis decreased mortality from 94 to 63% (p less than 0.05); 34 patients primarily with isolated stab wounds, were treated nonsurgically with pericardiocentesis and observation, only 50% were unstable and there was 15% mortality. Recurrent tamponade did not significantly increase overall or operative mortality in patients with pericardiocentesis.early, even presumptive, diagnosis of tamponade; immediate pericardial decompression via pericardiocentesis; and rapid transfer to OR for thoracotomy or sternotomy and cardiorrhaphy with continous pericardial decompression via intrapericardial catheter.

From March, 1969, through June 1976, 108 porcine aortic xenograft valves were used for mitral or aortic valve replacement in 95 patients. This experience provides one of the longest follow-ups available for evaluation of the porcine bioprosthesis. The first fifteen valves were locally mounted on Cutter stents and preserved in buffered formalin. Subsequent valves were prepared by the Edwards and Hancock Companies with glutaraldehyde preservation. Oral anticoagulation was routinely used for the first 6 weeks following surgery. Hospital mortality was unrelated to the valve type. All but four of the surviving patients with formalin preserved valves have required reoperation because of valve failure. There have been two valve failures in the patients who received gluteraldehyde valves, but there have been no embolic or thrombotic complications. Late cardiac catheterization has shown hemodynamic results equal to or better than prosthetic valves. The continuing long-term results indicate that the porcine xenograft is the valve of choice for cardiac valve replacement.

THE CONCEPT of surgical excision as a treatment for myocardial infarction was proposed by Murray, 1 who in 1947 observed improvement in cardiac function after excision of experimentally produced infarcts. Experimental and clinical studies by Heimbecker et al 2 demonstrated the feasibility of this method of treatment and stimulated our interest in the problem. Our own experimental results, 3 as well as those of Jude et al, 4 support the work of Heimbecker. Our experimental and clinical experience with this form of treatment is described in this paper. Experimental Method Forty mongrel dogs weighing 13.0 to 20.2 kg were studied. Animals were anesthetized with intravenously administered pentobarbital sodium and respiration was supported by endotracheal insufflation with room air using a respirator. The inferior vena cava was catheterized via the right femoral vein for central venous pressure measurements. The left femoral vein was cannulated for infusion of fluids and for dye