[Subendocardial resection in the surgical treatment of ventricular arrhythmia in patients with ischemic heart disease].
The authors have much experience in diagnosing and managing ventricular arrhythmias in patients with coronary heart disease. In most cases, the arrhythmogenic areas are present in the subendocardium and surgeries aimed at improving myocardial revascularization prove to be frequently ineffective in managing arrhythmias. Subendocardial resection proposed by the authors was used in 284 patients. Mortality rates were in 15%, the deaths were mainly due to phenomena of heart failure. Positive results were achieved in 160 (67%) patients. To evaluate the efficacy of the surgical management, the authors consider it advisable to apply programmed endocardial stimulation. The value of pre- and intraoperative mapping is the most important factor that determines the outcome of the surgical management. Subendocardial resection should be regarded as the method of choice just at early stages of the disease in patients with recurrent ventricular tachycardias occurring after acute myocardial infarction.
Josephson
M
M
Miller
J
J
Hargrove
K
K
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000209:etiology / Q000401:mortality; D003327:Coronary Disease / Q000150:complications*; D003452:Cryosurgery / Q000379:methods*; D004699:Endocardium / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D013610:Tachycardia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*
Subéndokardial'naia rezektsiia v khirurgicheskom lechenii zheludochkovykh aritmiĭ u bol'nykh ishemicheskoĭ bolezn'iu serdtsa.