The Journal of Thoracic and Cardiovascular Surgery, Vol 84, 704-715, Copyright © 1982 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
The surgical treatment of ventricular tachycardias. Simple aneurysmectomy versus electrophysiologically guided procedures
J Ostermeyer, G Breithardt, R Kolvenbach, M Borggrefe, L Seipel, HD Schulte and W Bircks
Between 1971 and 1982, 41 patients were operated upon for recurrent
sustained ventricular tachycardia. All but three had severe coronary artery
disease with a history of myocardial infarction. In 10 patients (Group I)
simple aneurysmectomy with or without aorta-coronary bypass grafting was
done. Thirty-one patients (Group II) had an electrophysiologically guided
procedure, mainly partial or complete encircling endocardial ventriculotomy
(EEV) at the earliest source of electrical activity during ventricular
tachycardia. The results in the two groups indicate a clear superiority of
electrophysiologically guided procedures over a simple aneurysmectomy
regarding early and late disappearance of tachycardiac rhythm problems (p =
0.01); the differences between the two groups in hospital mortality (p =
0.43) and long-term survival are not significant. We compared our data with
results in 160 cases of simple aneurysmectomy and 224 cases of
electrophysiologically guided operations recently published in the
literature. This comparison confirms the higher efficiency of mapping-
guided procedures in eradicating ventricular tachycardias. The improvements
in hospital and long-term survival, again, are not significant.
