Medicine: Bold Operation

• Share

Early one spring morning, a husky young surgeon ran up 20 steps to the door of the University of Pennsylvania Hospital. Suddenly he felt a stabbing pain in his chest; he broke out in a cold sweat, gasped for breath. His colleagues rushed him off to bed. A few days after this heart attack they found that a blood clot had formed in one of the chambers of his heart.

Several days after, while still very sick, the young doctor felt an "agonizing pain" in his legs; they turned cold and blue. The clot had been dislodged from his heart, had traveled along the aorta (main heart artery) till it became stuck at the point where the artery branched in two, low in his back, just above his legs. Calling his nurse, the doctor told her he was doomed, reminded her of a patient who had the same kind of embolism, lost his legs and died.

This week, in the Annals of Surgery, Drs. Isidor Schwaner Ravdin and Francis Clark Wood told how they saved the life of their young colleague with one of the boldest operations in modern medicine—removal of an embolus from a main artery.

They gave him a local anesthetic, cut open the arteries high on each leg, broke up the blood clot with a special probe, then sucked out the pieces with a long, slender tube. As soon as his blood vessels were stitched up, the patient was given transfusions and large injections of heparin, a liver extract which prevents clotting. Immediately after the operation, said Drs. Ravdin and Wood, "the color and temperature of the right leg returned to normal." His left leg recovered more slowly. For almost two weeks after the operation, heparin was constantly dripped into his veins.

Within two months the young man was out of the hospital. The following winter he underwent an operation for severe appendicitis, recovered "uneventfully." Today, said the doctors, their colleague "has perfectly normal lower extremities . . . is working full time . . . playing golf, climbing stairs, practicing surgery."