|
Vesalius, Italy
Vesalius described the case of a patient who died of a ruptured
aorta after being thrown from a horse.
Djanelidze, YY (2.8.1883 - 14.1.1950)
Yustin Y. Djanelidze successfully
repaired a penetrating injury to the intra-pericardial ascending
aorta in St Petersberg, Russia on 27th October 1913.
The patient, a 20-year-old man, had
been brought into the emergency room with multiple stab wounds in
his head, chest, and right arm. There were no signs of pneumothorax
or cardiac tamponade. The patient was initially stable, and the
wounds were closed in standard fashion. However, 2 hours later,
the patient developed arrhythmia, tachypnea, cardiac tamponade,
and progressive rapid hemodynamic deterioration, and the decision
was made to operate.
There was a 3-cm stab wound at the
1st intercostal space left of the sternum, which Djanelidze extended
down 12 cm, parallel to the sternum. He removed the second rib,
transected the cartilage of the 3rd rib, and ligated the left internal
thoracic artery. The pericardium was opened, and a large amount
of fresh blood was evacuated. A wound, 8 mm in length, was found
on the ascending aorta about 1 cm from its origin at the heart.
Djanelidze repaired this wound with 3 interrupted sutures. The patient's
postoperative course was uneventful, and he was discharged 30 days
after surgery. Djanelidze presented the patient at the meeting of
the Russian Surgical Society in November 1913.
Lilienthal H. Thoracic surgery: the
surgical treatment of thoracic diseases. Philadelphia: WB Saunders,
1925:489
|

|