1. Surgery for atrial septal defect: from the first experiments to clinical practice 
Vladimir V. Alexi-Meskishvili, MD, PhD, Igor E. Konstantinov, MD 
The Annals of Thoracic Surgery 
Volume 76, Issue 1, Pages (July 2003)
DOI: /S (03)

2. Fig 1
Roy Cohn’s method of the atrial septal defect (ASD) closure by invagination and suturing of a portion of the right atrial wall to the septum. (1) Introduction of the suture from the outside of the right auricular wall, which attaches a portion of the auricular wall to the septum. (2) Introduction of the steel wire into the auricular muscle. The wire surrounds the portion of the muscle sutured to the ASD. (3) Relation of the steel wire to the portion of the auricular wall attached to the ASD. (4) Completely introduced steel wire and the beginning of the introduction of the running silk suture. (5) Detached portion of the auricular wall closes the ASD. (6) Closure of the right atrial wall. (Reprinted from Cohn R, Am Heart J; 1947;33:453–7 [9], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

3. Fig 2
Gordon Murray’s technique of atrial septal defect (ASD) closure. Arrows indicate application of anterior-posterior approximating mattress sutures to close the ASD with invaginated left and right auricles. (Reprinted from Bailey CP, et al, J Thorac Surg; 1953;26:184–219 [13], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

4. Fig 3
Forrest D. Dodrill’s experimental method of “clamp technique” showing instrument (interrupted line for the instrument part behind the heart) applied to atria. Inset a shows sutures in place and clamp released. Inset b shows clamp reapplied and defect of the atrial septum being made. (Reprinted from Dodrill FD, J Thorac Surg; 1949;18:652–62 [11], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

5. Fig 4
Henry Swan’s method of invaginating the atrial appendages on plastic buttons. (A) Plastic buttons positioned on the left and right appendages. (B) Inverted appendages approximated against atrial septum to close the atrial septal defect. (Reprinted from Bailey CP, et al, J Thorac Surg; 1953;26:184–219 [13], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

6. Fig 5
Alvin Merendino’s method of nonsuture closure of atrial septal defect by means of “onlay floating graft” of pedicled pericardium. (A) The index finger of the left hand is inserted through the right auricular appendage and positioned over the auricular septal defect. The heart probe is led through the opening in the left auricular tip until it engages the left index finger against the septal defect. (B) The pericardial pedicle is pulled through the left atrial appendage so that it rests snugly against the defect. The stem of the pericardial pedicle, which projects through the right auricle, is sutured to the auricular wall. Both auricular appendages are sutured. (Reprinted from Kiriluk LB, et al, American College of Surgeons Surgical Forum; 1951;2:199–204 [14], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

7. Fig 6
Antony Hufnagel’s buttons closed about septal defect. (Reprinted from Bailey CP, et al, J Thorac Surg; 1953;26:184–219 [13], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

8. Fig 7
Charles Bailey’s method of atrioseptopexy. (A) Digital exploration of septal defect through right auricular appendage. (B) Placement of the first suture of atrioseptopexy. (C) Progressive approximation of invaginated right atrial wall to periphery of septal defect. (D) Completion of atrioseptopexy. (Reprinted from Bailey CP, et al, J Thorac Surg; 1953;26:184–219 [13], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

9. Fig 8
Tyge Sondergaard’s method of circumclusion. (A) Schematic drawing of the septum after suture was placed; the dotted line indicates the developed cleavage. (B) The suture is pulled tight and the defect is closed. (AS = atrial septum; D = defect; VS = ventricular septum.) (Reprinted from Sondergaard T, et al, Acta Chir Scand; 1955;109:188–96 [19], with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

10. Fig 9
Method of Robert Gross of placing the sutures in the edges of septal defect, working through atrial well. (1) Atraumatic needle carrying No. 000 Deknatel silk: position of the needle in needle holder. (2) Left index finger exploring the septal defect and identifying its margin. (3) With the right hand, a 10-inch-long needle holder carries the needle into place, grasping 3 or 4 mm of the septal edge. (4) The needle holder is given to an assistant who keeps upward traction on it. The presenting point of the needle is palpated with left index finger and grasped with right angle clamp. (5) Original needle holder is removed, right angle clamp still grasping the needle. (6) Needle recovered. (Reprinted from Gross RE, et al, Surg Obst Gynecol; 1953;96:1–23, with permission.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )

11. Fig 10
F. John Lewis and Richard Varco with the rubberized blanket and cooling machine used in the world’s first successful open-heart operation. (Courtesy of University of Minnesota Archives.)
The Annals of Thoracic Surgery  , DOI: ( /S (03) )