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Pediatric Cardiology

, Volume 34, Issue 8, pp 1969–1971 | Cite as

Left Thoracoscopic Sympathectomy Used as Primary Therapy for a Young Child With Intractable Long QT Syndrome

  • Dingchao He
  • John P. Costello
  • Evan P. Nadler
  • Jeffrey P. Moak
  • Richard A. Jonas
  • Dilip S. NathEmail author
Case Report

Abstract

A 3-year-old boy with familial long QT syndrome type 2 presented with recurrent syncope despite adequate beta-blocker therapy. Two family members had experienced sudden cardiac arrest, and one other relative had experienced sudden cardiac death. Given the high risk for ventricular arrhythmia/syncope, the decision was made to perform primary cardiac denervation therapy through a minimally invasive approach without concomitant automatic cardioverter-defibrillator implantation. Using video-assisted thoracoscopic surgery, the left-sided sympathetic ganglia from T2–T5 were identified, and dissection along the sympathetic chain with transection of the corresponding rami along T2–T5 in addition to the lower half of the stellate ganglion was performed. The chest tube was removed on day 1 after surgery, and the patient was discharged on postoperative day 4. During 14 months of follow-up evaluation, no intervening episodes of ventricular arrhythmia or syncope and no symptoms of Horner’s syndrome were noted.

Keywords

Left cardiac sympathetic denervation Long QT syndrome Video-assisted thoracoscopic surgery 

Supplementary material

Supplementary material 1 (WMV 145361 kb)

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Dingchao He
    • 1
  • John P. Costello
    • 1
  • Evan P. Nadler
    • 2
  • Jeffrey P. Moak
    • 3
  • Richard A. Jonas
    • 1
  • Dilip S. Nath
    • 1
    Email author
  1. 1.Division of Cardiovascular SurgeryChildren’s National Medical CenterWashingtonUSA
  2. 2.Division of Pediatric SurgeryChildren’s National Medical CenterWashingtonUSA
  3. 3.Division of CardiologyChildren’s National Medical CenterWashingtonUSA

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