[Ablation of ventricular tachycardia in thoracotomy without artificial circulation]

Seventeen patients were operated on for ventricular tachycardia (VT). Closed heart radical surgeries destroying the arrhythmia substrate were made without employing extracorporeal circulation. A VT episode was inducible in 16 (94%) patients for VT intraoperative mapping. The tachycardia substrate was removed by cryodestruction, cryoisolation or both. A special cryoprobe was introduced into the ventricular cavity by placing the purse-string suture at its apex. VT paroxysms completely disappeared in 12 (70.6%) and could be arrested by medications in 2 (11.8%). Three (17.6%) patients had recurrent VT episodes following a surgery. One (6%) patients died on day 7 of postoperation. The method proposed impairs no heart physiological activity, which facilitates inductions of an episode and its mapping during a surgery. The closed heart surgery enables the method to be applied in patients at a high risk for surgeries by employing extracorporeal circulation.