The patient is a 39-year-old-man who had rheumatic heart disease and had undergone mitral and aortic valve replacements with mechanical St. Jude prostheses as well as tricuspid valve repair and a MAZE procedure 17 years previously. He was admitted with ventricular tachycardia (VT) and an implantable cardioverter-defibrillator (ICD) was implanted. Four months later, he was admitted again with VT, and attempts to manage the VT with drugs were not successful. We performed electro-anatomical mapping and ablation for VT by re-median sternotomy. His postoperative course was uneventful. At 15 months after surgery, no recurrence of VT was recognized.

A 70-year-old man who had undergone felt repair for a left ventricular free wall rupture associated with acute myocardial infarction at age 66. A computed tomography at 4 years postoperatively showed left ventricular pseudoaneurysm and a 1-cm perforating hole. A patch closure with a Dacron patch was performed using cardiopulmonary bypass under ventricular fibrillation through a left thoracotomy. The postoperative course was uneventful and he was discharged on the 18th postoperative day.