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Ann Thorac Surg 2007;84:286-288
© 2007 The Society of Thoracic Surgeons

Case Reports

Surgical Cryoablation for Life-Threatening Postoperative Junctional Tachycardia

Alexander J. Tsoutsinos, MDa,*, John Papagiannis, MDa, Andrew C. Chatzis, MDb, George E. Sarris, MDb

a Department of Pediatric Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece
b Department of Pediatric and Congenital Heart Surgery, Onassis Cardiac Surgery Centre, Athens, Greece

Accepted for publication February 20, 2007.

* Address correspondence to Dr Tsoutsinos, Department of Pediatric Cardiology, Onassis Cardiac Surgery Centre, 356 Sygrou Ave, Kallithea, Athens, 17674, Greece (Email: tsutsi{at}otenet.gr).

Junctional ectopic tachycardia is usually a limited but potentially life-threatening postoperative arrhythmia. We describe a case of malignant postoperative junctional ectopic tachycardia in a 13-month-old child who had undergone transatrial and transpulmonary repair of tetralogy of Fallot resistant to all conventional therapeutic measures and complicated by recurrent ventricular tachycardia. The arrhythmia was finally treated by open surgical cryoablation of the atrioventricular node and the implantation of a permanent pacemaker. The patient made an uneventful recovery followed by good long-term outcome.






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