Abstract
Before entering upon the discussion of the subject matter, we will take this opportunity to pay our tribute to the pioneer in the surgery of blood vessels. On the eighteenth of last April, Dr. N. V. Eck died in St. Petersburg. Nearly a decade ago he succeeded in uniting the portal vein to the cava in a dog, thus performing the operation for the Eck fistula.
Carrel demonstrated that it is not only possible to unite the two ends of a severed artery by a circular suture, but also to interpose between the cut ends a segment of an artery of another animal and perform a double anastomosis. The success of the operation is due to the fine technique elaborated by Carrel.
Now, the question arises, upon what does this success depend? This question has not only a technical, operative, but a general physiological interest. To implant an arterial segment successfully means to avoid an intravascular thrombus after the operation.
According to the generally accepted theory of Briicke, blood remains fluid as long as it circulates in a vessel lined with an unimpaired living endothelium. Should the endothelium be injured through infection or trauma, a thrombus must form. In Carrel's experiments with implantation of arterial segments of the same species of animals, it seemed probable that the implanted segments remained alive. But in implantation of arterial segments of different animal species, the question presented itself whether these segments really remain alive, or, whether it is possible to implant devitalized arterial segments and the theories of intravascular coagulation of blood have-to be revised, Our experiments consisted in implantations of a segment of an aorta from a dog, about one inch long, hardened in 4 per cent. formalin, into the abdominal aorta of another dog.
Get full access to this article
View all access options for this article.