Ablation of idiopathic ventricular tachycardia arising from posterior mitral annulus in an 11-month-old infant by transapical left ventricular access via median sternotomy

Trans-apical catheter ablation of ventricular tachycardia in a patient with metallic aortic and mitral valves

We present a patient with a history of heart failure and metallic aortic and mitral valves surgeries, who required ablation for a drug-refractory left ventricular tachycardia. But the metallic valves prohibited the insertion of catheters via retrograde or via trans-septal approaches. Therefore, we decided to perform catheter ablation by direct left ventricle puncture through a minithoracotomy. The arrhythmia was successfully ablated via of trans-apical approach and did not recur at six months follow-up.