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Ueber penetrirende Herzwunden und Herznaht (pp.315-329).
Arch. klin. Chir., 55. - Berlin, Verlag von August Hirschwald, 1897, 8, V, 899 pp., Abb. im Text, 16 Taf., Halbledereinband der Zeit. ERSTE AUSGABE - MEILENSTEIN DER HERZCHIRURGIE - ERSTE HERZNAHT BEIM MENSCHEN! "Kein anderes Organ des Menschen war lange Zeit mit so vielen Tabus behaftet wie das Herz, und noch im Jahre 1896 äußerte Stephan Paget die Meinung: "...keine neue Methode und keine neue Entdeckung kann die naturgegebenen Schwierigkeiten überwinden, die eine Herzwunde mit sich bringt"." Seit Ludwig Rehn in Frankfurt erstmals eine Herzstichwunde erfolgreich vernähte, gilt das "als Beginn der Herzchirurgie". Diese Tat wurde vollbracht in einer Ära, in der kein geringerer als Billroth sagte:"Ein Chirurg, der die Naht einer Herzwunde versuchen wollte, sollte den Respekt seiner Kollegen sicher verlieren". "Rehn selbst war, als er den Eingriff wagte, noch stark mit der Vorstellung behaftet, daß eine so einschneidende Manipulation am Herzen wie eine durch die Ventrikelmuskulatur gestochene Naht mit irreversilblem Kammerflimmern beantwortet werden müßte." -cf. F.W.Hehrlein "Paget's prediction ("Surgery of the heart has probably reached the limits set by nature to all surgery....) was shattered on September 9, 1896, by Ludwig Rehn of Franfort, Germany. Rehn was born in 1849. In 1870 he interrupted his university career, volunteered as a Hussar, and accompanied the German armies into France. Upon his return to Germany he obtained his doctorate at Marburg. During his liefetime he made many contributions to surgery, but his most famous was the first successful suture of a human heart wound." "A man, aged 22, was stabbed with a knife in the fourth interspace, three fingerbreadths to the left of the sternal margin. After a period of unconsciousness, which lasted three hours, the patient revived sufficiently to take about 300 paces, when he fell to the ground. He was later found almost lifeless and was taken to the hospital. The first day following the injury the sensorium cleared, and the pulse became stronger and the dyspnea developed and the operation was performed. An incision 14 cm long was made in the fourth left interspace and fifth rib was divided in the mammary line. The pleura was opened. Blood distended the pericardium and oozed from the stab wound which entered it. The pericardium was opened widely and the blood within it was removed. A wound 1.5 cm long was found in the right ventricle from which there was active bleeding. This was controlled by placing a finger over the wound, but difficulty was experienced in keeping the finger properly in place. There was lees bleeding during diastole than during systole. The wound was closed with three silk sutures placed during several diastolic phases. The pulse was immediately improved. After the blood was removed from the pleural and pericardial cavities an iodoform gauze drain was placed in each... The patient recovered and was able to return to work." "This marked the beginning of cardiac surgery for the first time a surgeon had successfully operated on a living human heart." ! S.L.Johnson, The History of Cardiac Surgery 1896-1955, p.4 - 6. Garrison & Morton No.3023.1
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