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Video-Assisted Thoracoscopic Cardiac Denervation: A Potential Novel Therapeutic Option for Children With Intractable Ventricular Arrhythmias  Joseph Atallah,

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Presentation on theme: "Video-Assisted Thoracoscopic Cardiac Denervation: A Potential Novel Therapeutic Option for Children With Intractable Ventricular Arrhythmias  Joseph Atallah,"— Presentation transcript:

1 Video-Assisted Thoracoscopic Cardiac Denervation: A Potential Novel Therapeutic Option for Children With Intractable Ventricular Arrhythmias  Joseph Atallah, MD, Francis Fynn-Thompson, MD, Frank Cecchin, MD, Daniel J. DiBardino, MD, Edward P. Walsh, MD, Charles I. Berul, MD  The Annals of Thoracic Surgery  Volume 86, Issue 5, Pages (November 2008) DOI: /j.athoracsur Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 (A) The parietal pleura is scored with electrocautery at the T5 level, revealing the underlying left sympathetic chain, which runs along the posterior chest wall just medial to the heads of the ribs. (B) The parietal pleural incision is carried up to the T1 level with electrocautery, and the sympathetic chain is divided at the T1 and the T5 level and then isolated by division of all lateral branches. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Illustration in the coronal plane demonstrating the right and left sympathetic chains in the thoracic paravertebral space. Labels and a caption demonstrate the stellate ganglion and the sites of the left cardiac sympathetic denervation at the levels of T1 and T5, including the lateral nerve branches. (B) Illustration in the transverse plane at the level of T5 demonstrating the video-assisted thoracoscopic surgery approach to the left sympathectomy. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Bidirectional tachycardia during exercise testing in a patient with catecholaminergic polymorphic ventricular tachycardia. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Failed implantable cardioverter-defibrillator cardioversion with a 17-J biphasic shock in a patient with catecholaminergic polymorphic ventricular tachycardia experiencing an episode of ventricular fibrillation. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

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