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題 名 | Endoaneurysmorrhaphy and Cryoablation for Postinfarction Left Ventricular Aneurysm with Ventricular Tachycardia=合併心室瘤內修補及冷凍燒灼術治療心肌梗塞後之左心室瘤及心室心搏過速 |
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作 者 | 陳威元; 賴曉亭; 施俊哲; | 書刊名 | 中華醫學會雜誌 |
卷 期 | 70:3 2007.03[民96.03] |
頁 次 | 頁117-120+CA21 |
分類號 | 416.262 |
關鍵詞 | 左心室瘤; 冷凍燒灼術; 心室心搏過速; Cryoablation; Endoaneurysmorrhaphy; Ventricular tachycardia; |
語 文 | 英文(English) |
英文摘要 | Background: Early reperfusion in the acute phase of myocardial infarction and better medical treatment of consequent heart failure and tachyarrythmia have decreased the incidence of massive myocardial infarction, left ventricular (LV) aneurysm and also postinfarction-sustained ventricular tachycardia (VT). However, for a number of patients, surgical ablation combined with aneurysm resection and myocardial revascularization remains a possible curative procedure. In this study, the efficacy of endoaneurysmorrhaphy and cryoablation was evaluated in patients with postinfarction LV aneurysm with VT. Methods: The medical records of 9 patients who underwent LV endoaneurysmorrhaphy and cryoablation for VT at Taipei Veterans General Hospital between January 1995 and August 2005 were reviewed retrospectively. Results: There were 8 men and 1 woman, with a mean age of 69.7 years (range, 52–77 years). Preoperative VT and LV aneurysm were found in all patients, who underwent extensive cryoablation at the transitional zone of scar and viable tissue without intraoperative mapping and LV remodeling with prosthetic patch. Associated procedure included coronary artery bypass grafting in 8 patients. During follow-up, no surgical or inhospital mortality were noted. There was 1 late sudden death at home 1.7 months after the operation. No recurrent VT was detected, and all patients showed improvement in New York Heart Association functional class (mean, 2.33 vs. 1.67; p = 0.025) and LV ejection fraction (mean, 26.3% vs. 34.1%; p = 0.021). Conclusion: In patients suffering from postinfarction LV aneurysm complicated with VT, combining cryoablation and endoaneurysmorrhaphy offers good arrhythmia control and clinical outcome. |
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