Observed need for an atraumatic manner of holding and occluding stomach and intestine led to the development of a Velcro sleeve applied to various modified gastrointestinal clamps and forceps. The sleeve was found to hold more securely with minimal coaptation than previously used instruments, and to hold more atraumatically with heavy coaptation.
An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
The recent introduction by Blalock (1) of an operative procedure for the successful treatment of the tetralogy of Fallot has focused considerable at- tention on the various manifestations of this con- dition.It has also indicated the need of more in- formation to aid in the diagnosis and prognosis, as well as in the preoperative and postoperative treatment of the patients with this disease.The pres- ent study is concerned particularly with the measurement of blood volume, hemoglobin, and plasma protein in 7 cases of tetralogy of Fallot, 4 cases of isolated septal defect, and 1 case each of Eisen- menger complex, isolated pulmonic stenosis, coarctation of the aorta, congenital mitral stenosis, and patent ductus arteriosus.Fallot (2), in 1888, described the complex of combined congenital cardiac defects of pulmonic stenosis, right ventricular hypertrophy, patent in- terventricular septal defects, and dextroposition of the aorta which is commonly referred to as the "Tetralogy of Fallot."It is a common congenital defect of the heart.It constitutes 77 per cent of the 110 cases of pulmonary stenosis and 66 per cent of 40 cases of pulmonary atresia in Abbott's (3) series of 1,000 cases.The Eisenmenger com- plex is much less common.It differs from Fal- lot's tetralogy by having no pulmonary stenosis or atresia.The prognosis is somewhat better, the average life span being 16 years compared to 12.5 years in Fallot's type (4).The oldest age of sur- vival recorded in either type is 60 years (5).The principal extracardiac pathology of Fallot's tetralogy is a generalized vascular distention, cap- illary hyperplasia (3), and increased tortuosity.This is accompanied by polycythemia and in- creased blood viscosity.Blood arteriovenous-oxygen difference is increased, and its per cent oxygen 1One of series of studies being conducted under a grant from the Research and Development Division, Office of the Surgeon General, United States Army.saturation is decreased.Cyanosis, usually present at rest, is increased on exertion, when dyspnea also appears.4
