Total disconnection of the right ventricular free wall: surgical treatment of right ventricular tachycardia associated with right ventricular dysplasia.

摘要: Arrhythmogenic right ventricular dysplasia is a myopathy that affects the free wall (RVFW) and gives rise to recurrent reentrant tachycardia (VT). Because entire ventricle potentially arrhythmogenic, ablating single site of VT may not eliminate arrhythmia. We developed an operation confine any arrhythmic activity arising from chamber: total disconnection RVFW left ventricle. performed in two patients with refractory associated arrhythmogenic dysplasia. At least sites or origin morphologically distinct were identified each patient. was carried out under normothermic cardiopulmonary bypass. An encircling incision made along attachment aortoventricular unit tricuspid annulus; coronary artery its branches intact. Electrical chambers became dissociated, confined chamber. Postoperatively, there no clinical evidence hemodynamic impairment (follow-up 4 months 3 months). Left function unchanged flow maintained by atrial contraction motion septum toward during systole. One patient had incessant for weeks. conclude feasible applicable originating diffusely diseased RVFW.