Myocardial resection is a surgical procedure in which a portion of the heart muscle is removed.
Myocardial resection is done to improve the stability of the heart function or rhythm. Also known as endocardial resection, this open-heart surgery is done to destroy or remove damaged areas of the heart that cause life-threatening heart rhythms. This procedure is often performed in people who have had a heart attack, in order to prevent future rapid heart rates. It is also used in people who have Wolff-Parkinson-White syndrome (a condition resulting in abnormal heart rhythm).
This is major surgery and should be the treatment of choice only after medications have failed and the use of an implantable cardioverter-defibrillator (a device that delivers electrical shock to control heart rhythm) has been ruled out.
After receiving a general anesthetic, an incision will be made in the chest to expose the heart. When the exact source of the abnormal rhythm is identified, it is removed. If there are areas around the source that may contribute to the problem, they can be frozen with a special probe to further ensure against dangerous heart rates. The amount of tissue removed is so small, usually only 2 or 3 millimeters, that there is no damage to the structure of the heart. On some occasions, aneurysms of the heart wall are removed as well.
Prior to surgery, the physician will explain the procedure, routine blood tests will be completed, and consent forms will be signed.
Immediately after surgery, the patient will be moved to a recovery room until the effects of anesthesia have worn off. The patient will then be transferred to the intensive care unit for further recovery. In the intensive care unit, the heart will be monitored for any disturbances in rhythm and the patient will be watched for any signs of post-operative problems.
The risks of myocardial resection are based in large part on the person's underlying heart condition and, therefore, vary greatly. The procedure involves opening the heart, so the person is at risk for the complications associated with major heart surgery such as stroke, shock, infection, and hemorrhage.
Anywhere from 5-25% of post-heart attack patients do not survive open-heart surgery. The survivors have a 90% arrhythmia-free one-year survival rate, (arrthymia is an irregular heart beat).
McGoon, Michael D., ed. Mayo Clinic Heart Book: The Ultimate Guide to Heart Health. New York: William Morrow and Co., Inc., 1993.
American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. <http://www.americanheart.org>.
Dorothy Elinor Stonely
Implantable cardioverter-defibrillator—A device placed in the body to deliver an electrical shock to the heart in response to a serious abnormal rhythm.
Wolff-Parkinson-White syndrome—An abnormal, rapid heart rhythm, due to an extra pathway for the electrical impulses to travel from the atria to the ventricles.