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Takuro Misaki
Go Watanabe
Takashi Iwa
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Ann Thorac Surg 1994;58:1380-1385
© 1994 The Society of Thoracic Surgeons

Articles

Surgical treatment of arrhythmogenic right ventricular dysplasia: Long-term outcome

Takuro Misaki, MD, Go Watanabe, MD*, Takashi Iwa, MD, Makoto Tsubota, MD, Hiroshi Ohtake, MD, Keiichi Yamamoto, MD, Yoh Watanabe, MD

Departments of Surgery (1), Toyama Medical and Pharmaceutical University, Toyama, and Kanazawa University School of Medicine, Kanazawa, Japan

Accepted for publication March 29, 1994.

* Address reprint requests to Dr Watanabe, Department of Surgery (1), Toyama Medical and Pharmaceutical University, Sugitani Toyama 2630, Toyama, Japan 930-01.

Eight male patients ranging from 15 to 51 years old (mean age, 36.3 years) underwent surgical treatment of ventricular tachycardia (VT) associated with arrhythmogenic right ventricular dysplasia. One patient had an associated left ventricular aneurysm. The earliest activation site was detected for 15 lesions, and delayed potentials were recorded during sinus rhythm in all patients. On the basis of the epicardial mapping, the origins of the VT foci in the right ventricle were resected. Cryoablation on the surrounding myocardium was performed. There were no surgical deaths or postoperative fatal complications. During long-term follow-up, there has been no recurrence of VT and no congestive heart failure in the 6 patients without left ventricular involvement. The 2 patients with LV involvement died late of either congestive heart failure or development of VT originating from the left ventricle. In conclusion, a surgical approach consisting of myocardial excision and cryocoagulation offers a curative treatment of VT associated with arrhythmogenic right ventricular dysplasia and yields excellent long-term results when the VT origin is well identified in the right ventricle.




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