Saturday Afternoon, May 17, 1958

2:00 P.M. Executive Session. (Limited to Active and Senior Members). Imperial Ballroom.

3:30 P.M. Scientific Session: REGULAR PROGRAM -Imperial Ballroom.

27. Intrathoracic Pheochromocytomas.

Herbert C. Maier and George H. Humphreys, II, New York, N. Y.

Our experience with intrathoracic pheochromocytomas suggests that such tumors are not as rare as the literature would seem to indicate. Since there are few tumors in which the patient's outlook is more markedly influenced by correct diagnosis and appropriate drug therapy during operative removal the current experience with these neoplasms is summarized. Unless the possibility of a pheochromocytoma is recognized on the basis of clinical and operative findings, a serious hypertensive or hypotensive crisis may occur. Awareness of the characteristic location of pheochromocytomas, knowledge of the nature of the metabolic disturbances associated with these tumors, and information on the gross appearance of the lesion within the thorax should enable the surgeon to institute the correct therapy. These features will be discussed and illustrative cases of intrathoracic pheochromocytoma presented.

28. Management of Staphylococcic Tension Pneumatoceles by Intracavitary Suction Tube Drainage.

Elton Watkins, Jr. and Alexander C. Hering (by invitation),

Boston, Mass.

The rising incidence of Staphylococcic pneumonia indicates that tension pneumatoceles seen in the course of this illness may present a serious problem in the future. We have seen extreme ventilatory difficulty in infants as a result of these tension cysts. Monaldi drainage has proved lifesaving in preventing the ballooning of cysts appearing during the course of the acute pneumonic episode. Methods have been devised for introduction of these tubes accurately under local anesthesia in small infants. The method is preferable to lobectomy in the presence of bronchopleural fistula with Staphylococcic empyema or when the toxicity of the primary pneumonic process precludes immediate thoracotomy.

29. Topography of the Human Coronary Arteries Considered in Relation to Cardiac Surgery.

Thomas N. James (by invitation) and George E. Burch (fey invitation).

Sponsored by Alton Ochsner, New Orleans, La.

Disturbances in cardiac rhythm and conduction of impulses are recognized as important problems in cardiac surgery. Although every attempt is made to spare conduction pathways and the S-A and A-V nodes, little attention has been directed to the blood vessels supplying these areas. This has been largely due to meager knowledge regarding their circulation.

In a study of 58 human hearts by injection of vinylite into the coronary arteries, followed by hydrochloric acid corrosion, observations on the blood supply to the conduction system have been made. The study provided a spatially oriented preparation of the heart chambers and vessels.

To demonstrate how blood supply to conduction centers may be disturbed during cardiac surgery, some surgical procedures in current use, such as purse-string repair for mitral insufficiency, the circumclusion technic for closing interatrial septal defects, transatrial cannulation of the venae cavae for cardiac bypass, and right ventriculotomy, will be discussed.

Potential hazards associated with these procedures will be presented, as well as those of related procedures. Some hazards include occlusion of the artery to the sino-atrial node occlusion of the artery to the atrioventricular node, and occlusion of the posterior descending ventricular artery.

7:00 P.M. Banquet and Dancing, Hotel Statler -

Imperial Ballroom.

Attendance limited to Members of the Association and their ladies, Invited Speakers and their ladies.

Dinner dress preferred.