Massive myocardial edema and inflow cannula obstruction due to epicardial surgical ventricular tachycardia cryoablation at time of left ventricular assist device implantation

Less invasive durable management of postoperative ventricular tachycardia storm after LVAD insertion

“…1,2 There are limited guidelines for the management of refractory VT in patients after LVAD implantation. Rao et al 3 previously described the use of stellate ganglion block in treating postoperative ventricular arrhythmias in an LVAD patient that had a VT ablation performed concurrently with LVAD implantation. Our patient had not previously had a VT ablation before successfully undergoing a stellate ganglion block.…”

Simultaneous epicardial ablation based on intraoperative electroanatomic mapping during left ventricular assist device implantation

“…The advantages are that the epicardial surface can be exposed during open‐chest surgery, left ventricular endocardium can be visualized through the ventriculotomy required for the placement of the LVAD inflow cannula, and mapping and ablation can be performed in a more stable state with a cardiopulmonary bypass. However, there have been reports of cannula occlusion because of acute myocardial edema 3 and LVAD thrombosis. 4 Therefore, careful preoperative evaluation and perioperative management are required before this procedure.…”