Article
Surgical treatment of ventricular tachycardia in postinfarction left ventricular aneurysm
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Authors
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Diana Diaz Vazquez
- HDZ NRW Bad Oeynhausen, Herzchirurgie, Bad Oeynhausen
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Ulrich Rosendahl
- Herzzentrum Lahr, Herzchirurgie, Lahr
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Stefan Bauer
- Herzzentrum Lahr, Herzchirurgie, Lahr
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Brigite Osswald
- HDZ NRW Bad Oeynhausen, Herzchirurgie, Bad Oeynhausen
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Jan Gummert
- HDZ NRW Bad Oeynhausen, Herzchirurgie, Bad Oeynhausen
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Jürgen Ennker
- Herzzentrum Lahr, Herzchirurgie, Lahr
| Published: | April 26, 2013 |
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Outline
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Introduction: The surgical ventricular restoration in patients with coronary artery disease and postinfarction left ventricular aneurysm can be extended to treat ventricular tachycardia. The aim of this study was to evaluate the left ventricular aneurysmectomy, with endocardial resection of the scar, to treat ventricular tachycardia in patients with postinfarction left ventricular aneurysm.
Material and methods: From 2004 to 2010, 23 patients (9 women, 14 men) with ventricular tachycardia and left ventricular aneurysm underwent surgical ventricular restoration with complete or partial resection of the scar. Retrospective analysis of medical files and preoperative and postoperative echocardiographic results was done. Arrhythmia control was evaluated by analysis of events registered by implanted defibrillators and by review of patient’s records.
Results: Mean postoperative follow-up was 182.69 days (Range 7-215 days). Mean age was 67.77+/-10.80 (43-83). All aneurysms were anterior. All patients underwent concomitant coronary artery bypass grafting. Surgical success rate in patients with preoperative spontaneous ventricular tachycardia was 62.5%. Inducible ventricular tachycardia was found in 3 patients of 12 who underwent postoperative programmed stimulation. The ejection fraction increased from 24.22%+/-6.22% to 42.11%+/-7.14% (p<0.05). The New York Heart Association class was improved from 2.67 to 1.82 (p<0.05). Hospital mortality was 4.34%. Six months survival was 91.30%, one year survival was 86.95% and two years survival was 82.60%.
Conclusion: The surgical ventricular restoration with endocardial resection of the scar is an effective treatment for postinfartion left ventricular aneurysm with ventricular tachycardia. Reduce the need for an implantable defibrillator in most patients. The increased of the ejection fraction and the improvement of the New York Heart Association class are statistical significant (p<0.05). The surgical treatment achieved satisfactory result regarding early mortality and survival.
