title: [Left cardiac sympathetic denervation in congenital ventricular arrythmias: initial experience].
abstract: BACKGROUND
  Left cardiac sympathetic denervation (LCSD) has been proposed as a second-line therapy for potentially lethal ventricular arrythmia with no response to the gold standard treatment with beta-blockers. It has been used mainly in channelopathies such as long QT syndrome (LQTS) and polymorphic cathecolaminergic ventricular tachycardia (PCVT).
  
  
  OBJECTIVE
  Analizing our preliminary experience in the treatment of congenital ventricular arrythmia with thoracoscopic LCSD.
  
  
  METHODS
  We have reviewed the first 5 LCSD performed in the last two years (2011-2013) to 5 female patients with a mean age of 8 years (1 month-15 years). The underlying disease was the LQTS in three and the PCVT in two.
  
  
  RESULTS
  Selective contralateral bronchial intubation was used in two cases and double-lumen tube in three. We performed in all cases T1 sympathicolysis, denervation of T2 ganglion and sympathicolysis of T3 and T5 levels. No intraoperatory nor postoperatory complications were observed. In four cases ventricular tachycardia disappeared after the procedure and in one case, although they did not completely disappeared, they could be better controled on medical therapy. Ventricular extrasystoles reappeared 17 months after the procedure in one PCTV case, but disappeared completely after T1-T5 left sympathectomy completion. With a mean follow-up time of 20 months, all patients are sympthom-free and continue on betablocker oral therapy.
  
  
  CONCLUSIONS
  Thoracoscopic DCSI is a safe and effective therapy for prevention of severe congenital ventricular arrythmias.
authors: Servicio de Cirugía Pediátrica. Hospital Sant Joan de Déu-Clínic. Universidad de Barcelona.
authors: X
authors: X
authors: Tarrado
authors: Servicio de Cardiología. Hospital Sant Joan de Déu-Clínic. Universidad de Barcelona.
authors: G
authors: G
authors: Sarquella-Brugada
authors: Servicio de Cirugía Pediátrica. Hospital Sant Joan de Déu-Clínic. Universidad de Barcelona.
authors: L
authors: L
authors: Saura
authors: Servicio de Cirugía Pediátrica. Hospital Sant Joan de Déu-Clínic. Universidad de Barcelona.
authors: A
authors: A
authors: Manzanares
authors: Servicio de Cirugía Pediátrica. Hospital Sant Joan de Déu-Clínic. Universidad de Barcelona.
authors: V
authors: V
authors: Julià
authors: Servicio de Cirugía Pediátrica. Hospital Sant Joan de Déu-Clínic. Universidad de Barcelona.
authors: J M
authors: JM
authors: Ribó
keywords: Long QT syndrome; Polymorphic cathecolaminergic ventricular tachycardia; Sympathectomy; Thoracoscopy