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Initially developed in the late 1970s, surgery was later displaced by other therapies (especially ICD) due to the complexity of the procedure and a relatively high operative mortality rate (10%-15%).4 Currently, direct surgical ablation or resection of the arrhythmogenic substrate is still an option in experienced centers. In the setting of CAD, the candidates for surgery are usually patients with prior MI who already have an ICD and present recurrent VT refractory to drugs and percutaneous ablation. The procedure requires accurate intraoperative mapping, and either map-guided (subendocardial resection, focal cryoablation) or substrate-guided (aneurysmectomy, encircling cryoablation, encircling endocardial ventriculotomy.
Guiraudon, G. , Fontaine, G. , Frank, R. , et al. Encircling Endocardial Ventriculotomy: A New Surgical Management of Ventricular Tachycardia Related to Myocardial Infarction. In E. Sandoe, D. G. Julian, and J. W.