Surgical management of patient with left ventricular aneurysm and ventricular tachycardia

Fadi Hage; Ali Hage; Hussein Al-Amodi; Aashish Goela; Lin-Rui Guo

doi:10.1177/2050313X211065881

Surgical management of patient with left ventricular aneurysm and ventricular tachycardia

SAGE Open Med Case Rep. 2021 Dec 17:9:2050313X211065881. doi: 10.1177/2050313X211065881. eCollection 2021.

Authors

Fadi Hage¹, Ali Hage¹, Hussein Al-Amodi¹, Aashish Goela², Lin-Rui Guo¹

Affiliations

¹ Division of Cardiac Surgery, Western University, London Health Sciences Centre, London, ON, Canada.
² Division of Cardiothoracic Radiology, Western University, London Health Sciences Centre, London, ON, Canada.

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.

Keywords: Left ventricular aneurysm; dilated cardiomyopathy; ventricular tachycardia.

Publication types

Case Reports