Hage F, Hage A, Al-Amodi H, Goela A, Guo LR. Surgical management of patient with left ventricular aneurysm and ventricular tachycardia.
SAGE Open Med Case Rep 2021;
9:2050313X211065881. [PMID:
34956646 PMCID:
PMC8695747 DOI:
10.1177/2050313x211065881]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/23/2021] [Indexed: 11/22/2022] Open
Abstract
The management of patients with dilated cardiomyopathy and large anterior ventricular
aneurysm presenting with ventricular tachycardia is not well-described. We report the case
of 45-year-old male who presented with recurrent episodes of prolonged polymorphic
ventricular tachycardia and previously failed medical management and endocardial and
epicardial transcatheter ablation. We performed a Dor procedure to exclude the left
ventricular aneurysm in conjunction with cryoablation to terminate his ventricular
tachycardia. This surgical approach was found to be successful with conversion of the
patient into normal sinus rhythm and restoration of the patient’s left ventricular
morphology and function. We also propose a methodology for the surgical management of
patients with left ventricular aneurysm and intractable ventricular tachycardia focused on
a discussion with the patient and the cardiac team about the options for treatment,
including surgery or continuing pharmacological and electrical cardioversion therapy,
choosing the surgical technique that would exclude the most diseased and akinetic
myocardial segment, and being more liberal with the use of cryoablation.
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