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05:26
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
[Coronary revascularization in patients with preoperative electrical storm]
1Department of Cardiovascular Surgery, Caress Sapporo Hokko Memorial Hospital, Sapporo, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 14, 2007
Summary
Surgical coronary revascularization for subacute myocardial ischemia with electrical storm is challenging. Off-pump surgery is not recommended, but left ventricular restoration with cryoablation shows promise for survivors.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Context:
- Subacute myocardial ischemia often presents with electrical storm.
- Severe left ventricular dysfunction is common in these patients.
- Previous implantable cardioverter-defibrillator (ICD) therapy was noted in three patients.
Purpose:
- To evaluate surgical coronary revascularization outcomes in patients with subacute myocardial ischemia and preoperative electrical storm.
- To assess the suitability of off-pump versus on-pump procedures.
- To explore the efficacy of left ventricular restoration (LVR) and cryoablation.
Summary:
- Five patients with severe left ventricular dysfunction and electrical storm underwent surgical revascularization.
- Procedures included on-pump coronary artery bypass grafting (CABG) with mitral valvuloplasty (MVP) and LVR with cryoablation, and off-pump CABG.
- One patient died postoperatively due to electrical storm; another experienced recurrent storms requiring intensive management. Four patients survived 2 years with no arrhythmias.
Impact:
- Off-pump CABG is not suitable for subacute myocardial ischemia with electrical storm.
- Left ventricular restoration combined with surgical cryoablation may be effective for indicated cases.
- Successful surgical management can lead to long-term survival and improved New York Heart Association (NYHA) functional class.
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