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Right ventricular disarticulation. An 18-year single centre experience

Lookup NU author(s): Dr James Doig, Dr John Bourke, Colin Hilton

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Abstract

Objective: Right ventricular disarticulation (RVD) is an accepted procedure in the treatment of ventricular tachycardia of right ventricular origin. We set out to review the long-term outcomes with RVD at our institution for patients with arrhythmogenic right ventricular dysplasia (ARVD) or refractory tachycardia. A renewed interest in this operation has come about in patients unable to tolerate implantable cardioverter defibrillators. Methods: Seventeen patients had RVD carried out between 1985 and 2003. There were 15 mates and 2 females. The age range was 14-72 (median: 34). Six patients had partial RVD and 11 a complete RVD. ARVD was confirmed in 15 patients at histology. Biventricular pacing was used post-operatively in the two most recent patients. Results: The follow-up was complete in 94% (16/17). The median follow-up was 13 years (0-18). The overall hospital mortality was 6% (1/17). Over the follow-up period there were three deaths 9, 11 and 17 years post-surgery. Heart transplantation due to biventricular failure was required in two patients. In the group followed up for more than 10 years the over all event free survival at 10 years was 77% (3/13). Conclusions: In cases of refractory ventricular tachycardia, where multiple antiarrhythmic medication, repeated catheter ablation and ICD insertion are unsuccessful at symptom control, RVD is an excellent antiarrhythmic procedure. In the long term, signs of biventricular failure present, possibly, dependent on the natural history of ARVD. The tong-term effect of biventricutar pacing on the disarticutated right ventricle is yet to be defined. (c) 2005 Elsevier B.V. All rights reserved.


Publication metadata

Author(s): Zacharias J, Forty J, Doig JC, Bourke JP, Hilton CJ

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: European Journal of Cardio-Thoracic Surgery: 18th Annual Meeting of the European Association for Cardiothoracic Surgery

Year of Conference: 2005

Pages: 1000-1004

ISSN: 1010-7940

Publisher: Elsevier BV

URL: http://dx.doi.org/10.1016/j.ejcts.2005.02.020

DOI: 10.1016/j.ejcts.2005.02.020

Library holdings: Search Newcastle University Library for this item

ISBN: 1873734X


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