Characteristics and Outcomes of Ventricular Tachycardia and Premature Ventricular Contractions Ablation in Patients with Prior Mitral Valve Surgery

Background: Data regarding ventricular tachycardia (VT) or premature ventricular complex (PVC) ablation following MVS is limited.) CA can be challenging given perivalvular substrate in the setting of mitral annuloplasty or prosthetic valves. Objective: To investigate the characteristics, safety, and outcomes of radiofrequency catheter ablation (CA) in patients with prior mitral valve surgery (MVS) and ventricular arrhythmias (VA). Methods: We identified consecutive patients with prior MVS who underwent CA for VT or PVC between January 2013- December 2018. We investigated the mechanism of arrhythmia, ablation approach, peri-operative complications, and outcomes. Results: In our cohort of 31 patients (77% men, mean age 62.3±10.8 years, left ventricular ejection fraction 39.2±13.9%) with prior MVS underwent CA (16 VT; 15 PVC). Access to the left ventricle was via transseptal approach in 17 patients, and a retrograde aortic approach was used in 13 patients. A combined transseptal and retrograde aortic approach was used in one patient, and a percutaneous epicardial approach was combined with trans-septal approach in 1patient. Heterogenous scar regions were present in 94% of VT patients and scar-related reentry was the dominant mechanism of VT. Clinical VA substrates involved the peri-mitral area in 6 patients with VT and 5 patients with PVC ablation. No procedure-related complications were reported. The overall recurrence-free rate at 1-year was 72.2%; 67% in the VT group and 78% in the PVC group. No arrhythmia-related death was documented on long-term follow-up. Conclusion: CA of VAs can be performed safely and effectively in patients with MVS

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Polymorphic ventricular tachycardia after mitral valve surgery – a case report

Medical Science and Technology ◽

10.12659/mst.883795 ◽

2013 ◽

Vol 54 ◽

pp. 22-25

Author(s):

Wojciech Kustrzycki

Keyword(s):

Ventricular Tachycardia ◽

Case Report ◽

Mitral Valve ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Polymorphic Ventricular Tachycardia

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Nonischemic Mitral Regurgitation: Prognostic Value of Nonsustained Ventricular Tachycardia after Mitral Valve Surgery

Cardiology ◽

10.1159/000347085 ◽

2013 ◽

Vol 124 (2) ◽

pp. 108-115 ◽

Cited By ~ 9

Author(s):

Oladipupo Olafiranye ◽

Clare A. Hochreiter ◽

Jeffrey S. Borer ◽

Phyllis G. Supino ◽

Edmund M. Herrold ◽

...

Keyword(s):

Ventricular Tachycardia ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Prognostic Value ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Nonsustained Ventricular Tachycardia

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Management of late onset recurrent ventricular tachycardia following circumflex artery injury during minimally invasive mitral valve replacement surgery – Clinical case report

Acta Marisiensis - Seria Medica ◽

10.2478/amma-2021-0013 ◽

2021 ◽

Vol 67 (2) ◽

pp. 127-129

Author(s):

Timea Magdolna Szabo ◽

Mihaela Ispas ◽

Ayman Elkahlout

Keyword(s):

Myocardial Infarction ◽

Ventricular Tachycardia ◽

Mitral Valve ◽

Minimally Invasive ◽

Valve Replacement ◽

Mitral Valve Surgery ◽

Valve Surgery ◽

Circumflex Artery ◽

Replacement Surgery ◽

Valve Replacement Surgery

Abstract Introduction: A rare complication of mitral valve surgery is the injury of the circumflex artery due to their close anatomical proximity resulting in a perioperative myocardial infarction and subsequent fibrosis with increased risk of developing ventricular arrhythmias. Case presentation: We hereby describe the case of a 74-year-old male patient who underwent minimally invasive mitral valve replacement surgery for severe mitral regurgitation two weeks prior to presenting to the emergency department with dyspnea, palpitations and slight thoracic discomfort. He was diagnosed with recurrent sustained monomorphic ventricular tachycardia due to inferior wall myocardial infarction. Angioplasty of the culprit lesion was attempted, but the procedure failed due to the elastic recoil of the vessel. Our patient received antiarrhythmic therapy and an implantable cardioverter-defibrillator for secondary prevention of sudden cardiac death, with no further recorded episodes of ventricular tachycardia. Conclusion: Although injury of the circumflex coronary artery during mitral valve surgery is described as rare, we strongly believe that increasing awareness of the potential risks involved can further prevent fatal complications.

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