INTRODUCTION With the advent of asepsis, surgery emerged from the doldrums, where it had stood for centuries, and entered a period of unprecedented activity and advancement. A new era, that of operative development, had suddenly dawned. With bountiful promise for every new endeavor, surgery advanced from the beginning to almost the end of that great period in a mere half century. Within the short span of a surgeon's life this historic development could have been seen in panoramic view. Perfected and diversified as this development has been, surgery of the central circulatory system, of the heart with its pericardium, has not kept pace with the advancement in other fields. The foundation for the development of cardiopericardial surgery has not yet been completely assembled.1 This last great "Northwest of Surgery" stands today in a position scarcely more favorable than that occupied by abdominal surgery when the great Mikulicz advocated exploratory