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THE NEW PHYSIOLOGIC SURGERY ON THE HEART

JAMA. 1941;117(6):452-453. doi:10.1001/jama.1941.02820320044010.
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Until its modern period surgery was largely concerned with the removal of diseased parts of the human body. This type of surgery, while beneficial, is essentially the surgery of mutilation. No doubt legs will continue to be amputated, appendixes will be removed, parts of the brain will be ablated. Nevertheless the present trend of surgery is reconstructive, plastic, physiologic. The interesting surgery on the heart now under investigation in several institutions illustrates this exploration toward future progress.

The heart is anchored in the body by the great vessels at its base. This anatomic arrangement deprives the organ of continuity with adjacent tissues; physiology teaches that continuity is essential for the development of blood vessels from one structure to another. If continuity is given between myocardium and the parietal pericardium, mediastinal or omental fat or skeletal muscle, anastomoses will develop between the coronary arteries and the arteries of the grafted tissues.

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