CLOSURE OF LARGE ATRIAL SEPTAL DEFECT BY THE METHOD OF BJÖRK AND CRAFOORD

Cardiac surgeons have made sporadic attempts to devise a suitable method of closure of atrial septal defects for some time. Cohn1 in 1947 invaginated the atrial wall, sewed it to the edges of experimental defects, and cut loose the fixed portion of the wall. Murray2 in 1948 proposed and used in patients a method of direct closure by suture that appears, from his description of the operation, to resemble the method described below. At the time of writing of Murray's article, one of his patients who seemed clearly to have had an atrial septal defect was doing very well after the operation. Others3 have devised methods of suture or methods using prostheses that have functioned well in animals but have not done well or have not been tried in human beings. Gross and others4 report success in three of six instances of operative closure of atrial