title: Video-assisted thoracoscopic cardiac denervation: a potential novel therapeutic option for children with intractable ventricular arrhythmias.
abstract: BACKGROUND
  Left cardiac sympathetic denervation is one of the therapeutic modalities used in the management of patients with medically refractory long QT syndrome. Traditionally, a thoracotomy or cervical incision has been used as the standard surgical approach for performing left cardiac sympathetic denervation. Video-assisted thoracoscopic surgery allows a minimally invasive technique. There is only one published series on the use of video-assisted thoracoscopic surgery for left cardiac sympathetic denervation in patients with long QT syndrome.
  
  
  METHODS
  We performed a retrospective clinical review of pertinent medical records and report a series including 9 pediatric patients (4 long QT syndrome, 4 catecholaminergic polymorphic ventricular tachycardia, and 1 idiopathic ventricular tachycardia) who underwent a left cardiac sympathetic denervation by means of video-assisted thoracoscopic surgery.
  
  
  RESULTS
  There were no severe complications, and 6 of 7 symptomatic patients with available follow-up experienced marked improvement in the first month after sympathectomy.
  
  
  CONCLUSIONS
  This minimally invasive procedure provides a safe novel therapeutic option for children with drug-refractory catecholaminergic polymorphic ventricular tachycardia and other catecholamine-triggered arrhythmias.
authors.affiliation: Department of Cardiology, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Atallah
authors.forename: Francis
authors.initials: F
authors.lastname: Fynn-Thompson
authors.forename: Frank
authors.initials: F
authors.lastname: Cecchin
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: DiBardino
authors.forename: Edward P
authors.initials: EP
authors.lastname: Walsh
authors.forename: Charles I
authors.initials: CI
authors.lastname: Berul
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008133:Long QT Syndrome / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013562:Sympathectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods; D014693:Ventricular Fibrillation / Q000601:surgery*