110 ANEURYSMECTOMY AND SURGICAL ABLATION: WHEN?

Abstract A 60-year-old man with a previous myocardial infarction was admitted to our ICU for acute pulmonary edema in the context of an antero-lateral non-ST elevation infarction. Echocardiography showed severe left ventricular (LV) dilatation extensive wall motion abnormalities, large apical aneurysm and systolic dysfunction. Coronary angiography triple-vessel disease proximal occlusion anterior descending artery. During hospitalization, multiple episodes drug-resistant monomorphic tachycardias occurred, requiring repeated DC Shock. After Heart Team discussion, patient underwent coronary artery bypass grafting, LV restoration according procedure described by Guilmet surgical cryoablation. The septoexclusion is indicated when interventricular septum more involved than free wall. incision, cryolesions were applied at transitional zone scar viable tissue. Thus, sewn obliquely septum. Finally, edges septal, together assure definitive hemostasis (overcoat technique). surgery, implantable cardioverter-defibrillator implanted secondary prevention. postoperative course subsequent cardiological follow-up characterized gradual clinical improvement mild increasing function reduction arrhythmias. Nowadays, combined aneurysmectomy endocardial ablation are rarely performed, but should be considered patients who manifest Encircling cryoablation remodelled ventricle safe effective reducing arrhythmias which negative prognostic factor.