| Shogo Mukai* |
Yasushi Kawaue** |
Taijiro Sueda*** |
(Department of Cardiovascular Surgery, National
Hospital Kure Medical Center*, Hiroshima, Japan, Department of
Cardiovascular Surgery, Hiroshima General Hospital**, Hiroshima,
Japan and The First Department of Surgery, Hiroshima University
School of Medicine***, Hiroshima, Japan)
|
A 36-year-old man underwent partial
left ventriculectomy (PLV) to treat end-stage dilated hypertrophic
cardiomyopathy. Mitral valve replacement and tricuspid valve
annuloplasty were performed to correct the mitral and tricuspid
valve insufficiency. The patient suffered ventricular tachycardia
and ventricular fibrillation (VT/VF) soon after surgery, but
antiarrhythmic-drug therapy was sufficiently effective to treat
the VT/VF. On the third postoperative day, an implantable cardioverter-defibrillator
(ICD) was implanted to prevent these arrhythmias. Two months
later after his discharge from the hospital, recurrent VT/VF
appeared and was supposedly associated with renal failure. Continuous
hemodialysis was efficacious to ameliorate the systemic circulation,
and ventricular arrhythmias disappeared. He survived due to 18
ICD shocks. In appropriately selected patients, ICDs have been
recognized as one of the cost-effective therapeutic options.
ICDs might be recommended for patients in the postoperative period
of PLV who have potentially lethal ventricular arrhythmias resistant
to antiarrhythmic-drug therapy.
Jpn. J. Cardiovasc. Surg. 31: 205-208（2002) |
