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Posterior Left Thoracic Cardiac Sympathectomy by Surgical Division of the Sympathetic Chain: An Alternative Approach to Treatment of the Long QT Syndrome
Author(s) -
EPSTEIN ANDREW E.,
ROSNER MICHAEL J.,
HAGEMAN GILBERT R.,
BAKER JAMES H.,
PLUMB VANCE J.,
KAY G. NEAL
Publication year - 1996
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1996.tb03419.x
Subject(s) - medicine , sympathectomy , sympathetic denervation , stellate ganglion , efferent , sympathetic innervation , long qt syndrome , horner syndrome , cardiology , denervation , anesthesia , surgery , anatomy , afferent , qt interval , alternative medicine , pathology
Although high thoracic left Sympathectomy via art 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 Homer's syndrome.