Posterior left thoracic cardiac sympathectomy by surgical division of the sympathetic chain: an alternative approach to treatment of the long QT syndrome
| Autor: | Gilbert R. Hageman, Andrew E. Epstein, Vance J. Plumb, Michael J. Rosner, G. Neal Kay, James Baker |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
medicine.medical_specialty Horner Syndrome Time Factors medicine.medical_treatment Efferent Long QT syndrome Stellate Ganglion Torsades de pointes Ventricular tachycardia Surgical division Electrocardiography Internal medicine Medicine Humans Thoracic ganglia Surgical approach Intraoperative Care business.industry Heart General Medicine medicine.disease Ganglionectomy Long QT Syndrome medicine.anatomical_structure Sympathectomy Anesthesia Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Pacing and clinical electrophysiology : PACE. 19(7) |
| ISSN: | 0147-8389 |
| Popis: | Although high thoracic left sympathectomy via an anterior surgical approach is a highly efficacious treatment for refractory ventricular arrhythmias in patients with the long QT syndrome, the degree of sympathetic denervation has been variable, success of the operation is influenced by anatomical differences between patients, and Horner's syndrome may result. We hypothesized that interruption of sympathetic input to the heart could be accomplished using a posterior thoracic approach to this variable and often complex anatomy by division of the sympathetic chain rather than by direct destruction of the stellate and superior thoracic ganglia with the more conventional anterior, supraclavicular approach. In addition, the posterior approach should decrease the risk of Horner's syndrome by avoiding the ocular sympathetic efferent nerves. This posterior approach is described in five patients with the long QT syndrome and recurrent ventricular arrhythmias. After a mean follow-up of 18 +/- 12 months, all are alive without Horner's syndrome. |
| Databáze: | OpenAIRE |
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