The Annals of Thoracic Surgery, Vol 57, 921-924, Copyright © 1994 by The Society of Thoracic Surgeons
Surgical ablation of ventricular tachycardia secondary to congenital ventricular septal aneurysm
A Graffigna, G Minzioni, L Ressia and M Vigano
Istituto di Cardiochirurgia, Universita degli Studi di Pavia, Italy.
Three patients underwent surgical ablation for ventricular tachycardia
resulting from an aneurysm of the membranous portion of the ventricular
septum. Two patients had a definite history of cardiac murmur during
infancy, and one of them was found at the time of operation to have a
left-to-right shunt through the apex of the aneurysm. The earliest
ventricular activation sites were located around the neck of the aneurysm
and were ablated in 1 patient by encircling the endocardial ventriculotomy
and by cryoablation in the remaining 2. After focus resection had been
completed, aneurysm resection and ventricular septal reconstruction were
performed. All patients were alive and free of ventricular tachycardia and
did not need medication as of 61, 66, and 88 months postoperatively.
Spontaneous closure of a ventricular septal defect may lead to the
formation of an aneurysm in the ventricular septum that may sustain
ventricular tachycardias. Such arrhythmias can be effectively treated using
electrically guided surgical techniques.