[Variants of surgical treatment of ventricular tachycardia].
The paper presents the practice of the Hannover++ Surgery Center (FRG) in managing ventricular tachycardias: 122 patients underwent a radical operation by using electrophysiological studies, 92 patients were implanted an automatic cardioverter/defibrillator, 12 had homotopic cardiac transplantation. Coronary heart disease was present in 82%, non-ischemic heart disease was seen in 18%. The outcomes of operations with electrophysiological studies were as follows: deaths were 9% in early periods, relapses occurred in 5% of patients with coronary heart disease and in 46% of non-coronarogenic diseases. The cardioverter/defibrillator was implanted in 71 patients with coronary heart disease and 21 patients with non-coronarogenic diseases. The mean ejection fraction was 32%. The early and late mortality rates were 5 and 19%%, respectively. Out of 19 patients who had undergone transplantation, 17 were alive in follow-ups of 3 to 36 months. The ejection fraction before transplantation averaged 17%. The surgery for ventricular tachycardias with electrophysiological support is a highly effective method of therapy. The implantation of a cardioverter/defibrillator is regarded as a palliative intervention in patients with ventricular malfunction in the absence of an electrophysiological tachycardia substrate or in the presence of polymorphic tachycardia. Cardiac transplantation should be performed chiefly in young patients with evolving major disease. The transplantation may be replaced by implantation of a cardioverter if the former is impracticable or will be performed in future.
Frank
G
G
Lowes
D
D
Klein
H
H
Trappe
H
H
Borst
H
H
D000328:Adult; D000368:Aged; D003452:Cryosurgery / Q000379:methods*; D004554:Electric Countershock; D004699:Endocardium / Q000601:surgery*; D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D016027:Heart Transplantation; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D013610:Tachycardia / Q000209:etiology / Q000601:surgery*; D014693:Ventricular Fibrillation / Q000517:prevention & control
Varianty khirurgicheskogo lecheniia zheludochkovykh takhikardiĭ.