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.
This is a preview of subscription content, log in via an institution to check access.
References
Atallah J, Fynn-Thompson F, Cecchin F, DiBardino DJ, Walsh EP, Berul CI (2008) Video-assisted thoracoscopic cardiac denervation: a potential novel therapeutic option for children with intractable ventricular arrhythmias. Ann Thorac Surg 86:1620–1625
Chen L, Qin YW, Zheng CZ (1997) Left cervicothoracic sympathetic ganglionectomy with thoracoscope for the treatment of idiopathic long QT syndrome. Int J Cardiol 61:1–3
Collura CA, Johnson JN, Moir C, Ackerman MJ (2009) Left cardiac sympathetic denervation for the treatment of long QT syndrome and catecholaminergic polymorphic ventricular tachycardia using video-assisted thoracic surgery. Heart Rhythm 6:752–759
Crotti L, Celano G, Dagradi F, Schwartz PJ (2008) Congenital long QT syndrome (review). Orphanet J Rare Dis 3:18
Hwang SW, Thomas JG, Whitehead WE, Curry DJ, Dauser RC, Kim ES, Luerss TG, Jea A (2011) Left thorascopic sympathectomy for refractory long QT syndrome in children. J Neurosurg Pediatr 8:455–459
Li J, Liu Y, Yang F, Jiang G, Li C, Hu D, Wang J (2008) Video-assisted thoracoscopic left cardiac sympathetic denervation: a reliable minimally invasive approach for congenital long QT syndrome. Ann Thorac Surg 86:1955–1958
Reardon PR, Matthews BD, Scarborough TK, Preciado A, Marti JL, Conklin LD, Garson A, Reardon MJ (2000) Left thoracoscopic sympathectomy and stellate ganglionectomy for treatment of the long QT syndrome. Surg Endosc 14:86–87
Schwartz PJ, Priori SG, Cerrone M, Spazzolini C, Odero A, Napolitano C, Bloise R, Ferrari GM, Klersy C, Moss AJ, Zareba W, Robinson JL, Hall WJ, Brink PA, Toivonen L, Epstein AE, Li C, Hu D (2004) Left cardiac sympathetic denervation in the management of high-risk patients affected by the long QT syndrome. Circulation 109:1826–1833
Silver ES, Liberman L, Chung WK, Spotnitz HM, Chen JM, Ackerman MJ, Moir C, Hordof AJ, Pass RH (2009) Long QT syndrome due to a novel mutation in SCN5A: treatment with ICD placement at 1 month and left cardiac sympathetic denervation at 3 months of age. J Interv Card Electrophysiol 26:41–45
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Supplementary material 1 (WMV 145361 kb)
Rights and permissions
About this article
Cite this article
He, D., Costello, J.P., Nadler, E.P. et al. Left Thoracoscopic Sympathectomy Used as Primary Therapy for a Young Child With Intractable Long QT Syndrome. Pediatr Cardiol 34, 1969–1971 (2013). https://doi.org/10.1007/s00246-012-0511-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-012-0511-5