The Digital Exploration of the Ventricular Chambers of the Heart Through a Rubber Diverticulum *

If access to the ventricular chambers of the heart could be obtained without loss of blood or interruption of the normal functions of the heart, certain congenital and acquired lesions of the interior of the heart might be partially or completely corrected with minimal risk. The present investigation was stimulated by the needs of an infant in severe cardiac failure due to the presence of a ventricular septal defect. The correction of defects of the atrial septum with the use of an open rubber extension of the auricular appendage has recently been reported by Gross and his co-workers.8 The widespread acceptance by the surgeon of the operation for mitral valvulotomy has been largely due to the fact that there is loss of only a small amount of blood when the mitral valve is approached through the auricular appendage. It occurred to us that perhaps a closed rubber appendage, or what we would prefer to call a diverticulum, could be temporarily attached to the ventricles to permit a similar bloodless approach to the structures within these chambers. We do not have a definite answer to all the problems which were encountered in the development of this technique; but certain deductions can, however, be made from an experience with 26 dogs, when a diverticulum was sewed onto either the right or left ventricle and where an incision was made through the ventricular wall into the chamber. In 13 of these animals a ventricular septal defect had been made and the diverticulum was used as a method of approach to the ventricular chambers for repair of the defect. The results of these experiments will be reported at a later date.'