Ventriculotomy (cardiac)

A ventriculotomy is a surgical incision into a ventricle of the heart. The procedure is performed for various reasons, depending on the specific ventricle involved (left or right) and the underlying cardiac pathology. It is generally considered a major surgical procedure and requires significant postoperative care.

Types of Ventriculotomy

The type of ventriculotomy performed depends entirely on the reason for the surgery. While there aren't formally named subtypes, the approach and location of the incision will vary widely depending on the specific anatomical target and surgical goal. For instance, an incision might be required to repair a ventricular septal defect (VSD) between the ventricles, or to access the interior of the ventricle for the repair or replacement of a valve, removal of a thrombus, or biopsy. The surgeon will carefully plan the incision to minimize damage to surrounding structures and achieve the desired surgical outcome.

Indications for Ventriculotomy

Ventriculotomies are performed to address a range of cardiac conditions, including:

Ventricular Septal Defects (VSDs): Surgical repair of holes in the septum separating the ventricles.
Valve Repair or Replacement: Access to the ventricle is often necessary for mitral valve, tricuspid valve, or aortic valve procedures.
Removal of Intraventricular Thrombi: Blood clots forming inside the ventricles can be surgically removed.
Tumor Resection: Surgical removal of tumors located within the ventricle.
Myocardial Biopsy: Obtaining a tissue sample from the ventricular myocardium for diagnostic purposes.
Treatment of Ventricular Aneurysms: Repair of weakened areas in the ventricular wall.

Procedure

The procedure involves opening the chest cavity, exposing the heart, and making a controlled incision into the chosen ventricle. The exact surgical technique employed will depend heavily on the specific indication and the surgeon's preferences. Following the completion of the necessary repair or procedure, the incision is closed meticulously using sutures, and the heart is carefully inspected for any bleeding or damage.

Postoperative Care

Postoperative care following a ventriculotomy is intensive and often involves monitoring vital signs, managing pain, preventing infection, and addressing potential complications such as arrhythmias, bleeding, and pericardial effusion. Patients typically require a prolonged hospital stay and a period of rehabilitation.

Risks and Complications

As with any major cardiac surgery, ventriculotomy carries inherent risks and potential complications, including:

Bleeding
Infection
Arrhythmias
Heart failure
Stroke
Pericardial effusion
Death