[Surgical treatment of ventricular tachycardia after radical correction of tetralogy of Fallot].
The patient was 21 year-old male with recurrent sustained VT following complete repair of tetralogy of Fallot. He underwent complete repair of tetralogy of Fallot at the age of 3. Eight years after the operation, he first noted episode of tachycardia. Sustained VT was first documented 15 years after operation, and he required direct-current cardioversion for this tachycardia. Because of life threatening arrhythmia he was transferred to our hospital for surgical management. Sustained VT was induced and found to originate from the inflow-septal and outflow area of right ventricle. During the operation only right outflow type tachycardia could be induced by programmed stimulation. Diastolic fractionated local electrical activity, which suggested a reentrant circuit, was recorded at the outflow epicardial area. The outflow muscle (2 X 2 cm) showing the earliest excitation during VT was excised with cryocoagulation at the outflow tract. The resected area was closed with a Gore-Tex patch using continuous sutures. Another cryocoagulation was applied to the inflow-septal area prophylactically. After surgery, a so-called non-clinical VT was inducible, however this VT could be prevented by antiarrhythmic drugs. No spontaneous episodes of VT have been postoperatively observed for 2 months.
Misaki
T
T
Department of Surgery (1), Kanazawa University School of Medicine, Japan.
Tsubota
M
M
Tanaka
M
M
Watanabe
G
G
Watanabe
Y
Y
Iwa
T
T
D000328:Adult; D004562:Electrocardiography; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000601:surgery*; D013610:Tachycardia / Q000503:physiopathology / Q000601:surgery*; D013771:Tetralogy of Fallot / Q000601:surgery*