Sbrocchi Alexander J, Hardy William A, Ghannam Alexander D, Kilic Arman
Division of Cardiothoracic Surgery, Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
J Card Surg. 2022 Jun;37(6):1770-1772. doi: 10.1111/jocs.16423. Epub 2022 Mar 15.
Ventricular tachycardia (VT) can be a challenging problem in patients following durable left ventricular device (LVAD) implantation, and can lead to significant morbidity and mortality. Both the etiology and management of VT in this population can also vary substantially.
We herein report a case of a patient with preoperative VT who developed a drug resistant VT storm postoperatively that was ultimately controlled durably with a bedside stellate ganglion block.
This case illustrates that stellate ganglion block can be an effective and durable intervention for terminating refractory VT in LVAD patients. This method is attractive because it can be performed at the bedside in relatively unstable patients, and is less invasive than other alternatives such as VT ablation and thoracic sympathectomy.
室性心动过速（VT）对于植入耐用型左心室装置（LVAD）后的患者而言可能是一个具有挑战性的问题，并且可能导致严重的发病和死亡。该人群中室性心动过速的病因和治疗方法也可能有很大差异。
我们在此报告一例术前患有室性心动过速的患者，术后发生了耐药性室性心动过速风暴，最终通过床边星状神经节阻滞得到了持久控制。
该病例表明，星状神经节阻滞对于终止LVAD患者的难治性室性心动过速可能是一种有效且持久的干预措施。这种方法具有吸引力，因为它可以在相对不稳定的患者床边进行，并且比其他替代方法（如室性心动过速消融和胸交感神经切除术）侵入性更小。
