Walter S. Henly

Surgical Treatment of Dissecting Aneurysm of the Aorta Analysis of Seventy-Two Cases

Dissecting aneurysm of the aorta is an extremely serious condition that pursues a rapidly fatal course in more than 75 per cent of cases. Follow-up data on 72 patients surgically treated indicate that effective surgical treatment significantly alters the course of the disease and in the majority of instances removes the threat of death by rupture. The operative mortality rate in these 72 patients was 26 per cent. For lesions occurring distal to the left subclavian artery, resection of the descending thoracic aorta with replacement by aortic graft utilizing hypothermia or the bypass pump was successful in 80 per cent of cases. Most patients surviving operation have been able to resume previous activities with minimal risk of sudden death from rupture of the aneurysm or failure of the aortic graft. The importance of recognizing the characteristic clinical manifestations, of making precise roentgenographic diagnosis, and of instituting effective surgical treatment in the management of dissecting aortic aneurysm has been stressed.

VERTEBRAL ARTERIOGRAPHY BY AN INFRACLAVICULAR ROUTE.

Abstract Subclavian arteriography by an infraclavicular route has given satisfactory visualization of the extracranial and intracranial vertebral circulation in over 450 patients with minimal morbidity. Pneumothorax as a complication of subclavian arteriography has been virtually eliminated. This fact and certain lesser advantages of the technic have encouraged routine use of the method.

Surgical Treatment Of Angina Pectoris: A Fifty Year Retrospective From Baylor/Methodist

INTRODUCTION In 1961, we described the surgical treatment of coronary artery disease when surgeons were only beginning to realize that the mechanical blockages might be amenable to operation.1 This report reviews briefly the experimental and clinical approaches to the surgical treatment of coronary occlusive disease, including the role of the Baylor/Methodist investigators. In 1768, William Heberden2 first described the syndrome of angina pectoris, stating that “...the sense of strangling, and anxiety with which it is attended, may make it not improperly be called angina pectoris”. Edward Jenner3 was the first to correlate angina and coronary disease. His patient, John Hunter, died from calcification of the coronary arteries in 1793, as shown by autopsy. In a letter to Heberden, Jenner3 hypothesized a correlation between Hunters anginal attacks and the pathologic findings in the coronary arteries. Hunters angina attacks worsened, and although he did not know the cause, he described its manifestations an...

LINING OF AUTOGENOUS VEIN PATCH GRAFTS OF SMALL CANINE ARTERIES.

Summary The inner lining of autogenous vein patch grafts placed into small canine arteries by microsurgical techniques was studied. The grafts placed in 22 femoral arteries of 13 dogs were kept in place from 2 days to 76 weeks. Aortography disclosed patency of all the arteries grafted with no or slight dilatation at the site of operation. En face silver preparations disclosed that the intimal surfaces of the grafts were covered with endothelium after the 4th day. Endothelial cells were demonstrated in pellicle preparations. The patch contributed its own substance, particularly elastic fibers, to the repair of the arterial wall.