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January 1, 1929


Arch Surg. 1929;18(1_PART_II):386-402. doi:10.1001/archsurg.1929.04420020208015

The pericardium was approached from many different angles. There is no "triangle of safety" in the dog through which the pericardium can be opened without pneumothorax.

EXPERIMENTAL WORK ON ANIMALS  By one method, we resected three or four ribs and pushed the heart over toward the resected area by making pressure on the opposite side. The pericardium was sutured to the wall of the chest in this position with a series of sutures placed in a circular manner. A secondary operation was done several weeks later to open the pericardial sac, which we hoped would be adherent in the area of the previous suturing. This failed in six dogs because the adhesions were pulled out into a thin band, and in each instance the pleura was opened. Other routes of approach were directed through the tendonous portion of the diaphragm and beneath the resected ensiform cartilage. These also were unsatisfactory.

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