Division of Cardiothoracic Surgery, Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Ann Thorac Surg. 2022 Nov;114(5):e319-e320. doi: 10.1016/j.athoracsur.2022.01.009. Epub 2022 Jan 24.
Our case is a 73-year-old male patient with persistent ventricular tachycardia leading to recent syncopal episodes despite ventricular tachycardia ablation and multiple stellate ganglion blocks, frequent hospital admissions, and acute on chronic congestive heart failure requiring an intraaortic balloon pump. The decision was made to proceed with left ventricular assist device placement and bilateral sympathectomies simultaneously. After performing the sternotomy and widely opening bilateral pleural spaces, the lower third of the stellate ganglia to the level of T4 was removed using a combination of the thoracoscope with the sternotomy incision. The use of thoracoscopy greatly assisted with visualization during the sympathectomy.
我们的病例是一名 73 岁男性患者，尽管进行了室性心动过速消融术和多次星状神经节阻滞，但仍持续出现室性心动过速，并导致最近晕厥发作，患者频繁住院，且因慢性充血性心力衰竭急性加重而需要主动脉内球囊泵治疗。因此决定同时进行左心室辅助装置和双侧交感神经切除术。在完成胸骨切开术并广泛打开双侧胸膜腔后，使用胸腔镜和胸骨切开术切口联合切除星状神经节的下三分之一至 T4 水平。胸腔镜的使用极大地辅助了交感神经切除术的可视化操作。
