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Ligation of the inferior vena cava for the prevention of pulmonary embolism
SELECTED
243
~wrR~cTs
Barnes, Ariie R.: The Consideration of Two Cardiac Diseases Amenable ment. Journal-Lancet 65: 382 (Nov.) 1945.
to Surgical
Treat-
Barnes considers the minimal requirements for the diagnosis of patent ductus arteriosus to be, first, a continuous murmur (in the sense that there must be a diastolic as well as a systolic element), and second, roentgen evidence of some eniargement of the pulmonary conus. The diagnosis must be made with caution in the absence of an increased pulse hk;\III,I,AN. pressure.
Gaeton, E. A., and Folsom, H.: Pulmonary
Embolism.
Ligation England
New
of the Inferior J. Med. 233:
Vena Cava for 229 (lug. j 1W.i.
the
Prevention
of
Since venous thrombosis is a disease that frequently affects the vessels of butk Iewver extremities ligation of the inferior vena cava seems desirable, since this procedure nut onls interrupts the venous channel above an evident femoroiliac: thrombosis, but alro acts to prevent embolism from a simultaneous subclinical phlebothrombosis that probal~l~ rxi.qts The authors report two cases in which ligati,ln of in the veins of the opposite lower leg. the inferior vena cava was performed below the level of the renal veins. .\lth~~uyh an in seriously iI1 ~utirlilr. A operation of some magnitude, it is compatible with reeuver~ consideration of the available collateral pathways for venous return aruuntl tile point c!f ligation indicates that eventual return to a normal venous pressure relation sho111~1 ells~~. The indications for ligation of the inferior vena cava :tre not ~~11 defined. -Y prt‘tty to periplirr:ll ~~~~~11s clear indication is the occurrence of several pulmonary emholi sc,condary \I, Il. thrombosis. A review of the literature is also inclu~led in this rl!port.
Segall,
E. L., and Dorfman,
Papaverine
Death
W.:
Hydrochloride.
New
England
Pollowing J. Med.
the Intravenous 233: .i!lO /Oct.
Administration 1 l!l G.
of
Severe respiratory symptoms, hyperpnea, and tachypnt~n, devclr~pcd in tJ\ 0 ii;~lil~llls Ill I,l!tll 1l:itit’IitH within thirty seconds after the intravenous administration of papaverine. One patient, aged 80 years, had auriculur fi~rrillatioil death occurred within five minutes. The YecoIld patlclll> :i !;Iand, apparently, an embolism to the bifurcation of the aorta. year-old woman, suffered from pulmonary embolism with ini’:1rctilorl of the r~,:llt I~ITXL~I lung lobe. Since respiratory symptoms began so quickly, the authors feel justitiecl ifi :ctt riltnlirly \],,\I death to the medication.
Levine,
Samuel A., and Hindle,
England
J. Med.
233:
Coronary
J. A.:
657 (Nov.),
Artery
Disease
Among
Physicians.
Svw
1945.
Levine and Kindle have attempted to secure statistical data bearing on the widcJ> held opinion that coronary artery disease occurs more frequently in professional men, parThey felt that a comparison of the age at the ticularly physicians, than in other groups. time of death from coronary artery disease in different groups would more accurately answer this question than would a consideration of the number of reported deaths. Using 66.3 years as the average age of physicians at the time of death from all causes, their analysis showed that 65.8 years was the average age at death from curur~:lry artery disease both in physicians and in the general population. The difference 1, r1.3 nut significant. \I( 11.
Drury,
Alan N.: Observations Relating to Cardiac Hypertrophy Produced in the Rabbit by Arteriovenous Anastomosis, the Effect of Closure of the Anastomosis. Qu:~I.~. .I. Exper.
Physiol.
33:
107
(May)
1945.
Drury carried out a series of studies on rabbits dasigrmd to situ\v ( 1, ~vhcl hc-r rhe cardiac enlargement that develops after A-V anastomosia is the rehult rotlinly o!’ k~p~rtrul~k~ or of dilatation and (2) whether or not this enlargement disappears al’ter tile .\-I. ~:onucction is abolished. From the experiments reported in this paper, as well as from earlier work, tilts author is satisfied that very real cardiac hypertrophy develops within six to eight weeks after
243
~wrR~cTs
Barnes, Ariie R.: The Consideration of Two Cardiac Diseases Amenable ment. Journal-Lancet 65: 382 (Nov.) 1945.
to Surgical
Treat-
Barnes considers the minimal requirements for the diagnosis of patent ductus arteriosus to be, first, a continuous murmur (in the sense that there must be a diastolic as well as a systolic element), and second, roentgen evidence of some eniargement of the pulmonary conus. The diagnosis must be made with caution in the absence of an increased pulse hk;\III,I,AN. pressure.
Gaeton, E. A., and Folsom, H.: Pulmonary
Embolism.
Ligation England
New
of the Inferior J. Med. 233:
Vena Cava for 229 (lug. j 1W.i.
the
Prevention
of
Since venous thrombosis is a disease that frequently affects the vessels of butk Iewver extremities ligation of the inferior vena cava seems desirable, since this procedure nut onls interrupts the venous channel above an evident femoroiliac: thrombosis, but alro acts to prevent embolism from a simultaneous subclinical phlebothrombosis that probal~l~ rxi.qts The authors report two cases in which ligati,ln of in the veins of the opposite lower leg. the inferior vena cava was performed below the level of the renal veins. .\lth~~uyh an in seriously iI1 ~utirlilr. A operation of some magnitude, it is compatible with reeuver~ consideration of the available collateral pathways for venous return aruuntl tile point c!f ligation indicates that eventual return to a normal venous pressure relation sho111~1 ells~~. The indications for ligation of the inferior vena cava :tre not ~~11 defined. -Y prt‘tty to periplirr:ll ~~~~~11s clear indication is the occurrence of several pulmonary emholi sc,condary \I, Il. thrombosis. A review of the literature is also inclu~led in this rl!port.
Segall,
E. L., and Dorfman,
Papaverine
Death
W.:
Hydrochloride.
New
England
Pollowing J. Med.
the Intravenous 233: .i!lO /Oct.
Administration 1 l!l G.
of
Severe respiratory symptoms, hyperpnea, and tachypnt~n, devclr~pcd in tJ\ 0 ii;~lil~llls Ill I,l!tll 1l:itit’IitH within thirty seconds after the intravenous administration of papaverine. One patient, aged 80 years, had auriculur fi~rrillatioil death occurred within five minutes. The YecoIld patlclll> :i !;Iand, apparently, an embolism to the bifurcation of the aorta. year-old woman, suffered from pulmonary embolism with ini’:1rctilorl of the r~,:llt I~ITXL~I lung lobe. Since respiratory symptoms began so quickly, the authors feel justitiecl ifi :ctt riltnlirly \],,\I death to the medication.
Levine,
Samuel A., and Hindle,
England
J. Med.
233:
Coronary
J. A.:
657 (Nov.),
Artery
Disease
Among
Physicians.
Svw
1945.
Levine and Kindle have attempted to secure statistical data bearing on the widcJ> held opinion that coronary artery disease occurs more frequently in professional men, parThey felt that a comparison of the age at the ticularly physicians, than in other groups. time of death from coronary artery disease in different groups would more accurately answer this question than would a consideration of the number of reported deaths. Using 66.3 years as the average age of physicians at the time of death from all causes, their analysis showed that 65.8 years was the average age at death from curur~:lry artery disease both in physicians and in the general population. The difference 1, r1.3 nut significant. \I( 11.
Drury,
Alan N.: Observations Relating to Cardiac Hypertrophy Produced in the Rabbit by Arteriovenous Anastomosis, the Effect of Closure of the Anastomosis. Qu:~I.~. .I. Exper.
Physiol.
33:
107
(May)
1945.
Drury carried out a series of studies on rabbits dasigrmd to situ\v ( 1, ~vhcl hc-r rhe cardiac enlargement that develops after A-V anastomosia is the rehult rotlinly o!’ k~p~rtrul~k~ or of dilatation and (2) whether or not this enlargement disappears al’ter tile .\-I. ~:onucction is abolished. From the experiments reported in this paper, as well as from earlier work, tilts author is satisfied that very real cardiac hypertrophy develops within six to eight weeks after