Long-term outcomes after cryoablation for ventricular tachycardia during surgical treatment of anterior ventricular aneurysms.

Intraoperative map-guided procedures have been widely advocated as the best surgical strategy for the treatment of ventricular tachycardia (VT), though favorable results have been reported with subendocardial resection without mapping. This study examined the very long-term results of encircling cryoablation without mapping during surgery for anterior left ventricular aneurysm complicated by VT. Between 1985 and 2003, this procedure was performed in 52 patients, 7 of whom (13.7%) were operated within 1 month of anterior myocardial infarction. Their mean age was 64.4 +/- 8.3 years and mean left ventricular ejection fraction was 31.7%+/- 9.5%. The overall hospital mortality was 1.9%. At 14 years, 86% of patients (95% CI: 75.4-96.6) were free from VT or sudden death. An implantable defibrillator was implanted in five patients (9.6%) during follow-up. The 14-year overall survival was 51.4% (95% CI: 33.8-72.4), and two patients (3.8%) underwent cardiac transplantation during follow-up. The main cause of late death was congestive heart failure in eight patients (40.0%). Favorable long-term results can be achieved with encircling cryoablation without mapping in patients undergoing surgery for anterior left ventricular aneurysm complicated by VT.