The role of surgery in the treatment of post-infarction ventricular tachycardia. a 5 year experience
Martinelli, L.; Goggi, C.; Graffigna, A.; Salerno, J.A.; Chimienti, M.; Klersy, C.; Viganò, M.
Journal of Cardiovascular Surgery 28(4): 374-379
1987
ISSN/ISBN: 0021-9509 PMID: 3597529 Document Number: 296897
The purpose of this report is to present a 5 year experience in electrophysiologically guided surgical treatment of post-infarction ventricular tachycardia (VT) in a consecutive series of 39 patients. In every case the arrhythmia was not responsive to pluripharmacological therapy. The diagnostic steps included preoperative endocardial, intraoperative epi- and endocardial mapping, automatically carried out when possible. Surgical techniques were: classic Guiraudon's encircling endocardial ventriculotomy (EEV), partial EEV, endocardial resection (ER), cryoablation or combined procedures. The hospital mortality was of 4 patients (10%). During the follow-up period (1-68 mo), 4 patients (11%) died of cardiac non-VT related causes. Among the survivors, 90% are in sinus rhythm. The authors consider electrophysiologically guided surgery a safe and reliable method for the treatment of post-infarction VT and suggest more extensive indications. They stress the importance of automatic mapping in pleomorphic and non-sustained VT, and the necessity of tailoring the surgical technique to the characteristics of each case.