{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,4,16]],"date-time":"2023-04-16T04:15:10Z","timestamp":1681618510105},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4]]},"abstract":"OBJECTIVE<\/jats:title>Congenital long QT syndrome (LQTS) provides an opportunity for neurosurgical intervention. Medication and implantable cardiac defibrillator (ICD)\u2013refractory patients often require left cardiac sympathetic denervation (LCSD) via anterior video-assisted thoracoscopic surgery (VATS). However, this approach has major pulmonary contraindications and risks, with a common concern in children being their inability to tolerate single-lung ventilation. At Oregon Health & Science University, the authors have developed a posterior approach\u2014extrapleural, minimally invasive, T1\u20135 LCSD\u2014that minimizes this risk.<\/jats:p><\/jats:sec>METHODS<\/jats:title>A 9-year-old girl with LQTS type III presented to the emergency department while experiencing ventricular tachycardia (VT) and ventricular fibrillation (VF) with multiple ICD firings. Medical management failed to resolve the VF\/VT. VATS was attempted but could not be safely performed due to respiratory insufficiency. The patient was reintubated for dual-lung ventilation and repositioned prone. Her respiratory insufficiency resolved. Using METRx serial dilating tubes under the microscope, the left T1\u20135 sympathetic ganglia were sectioned and removed.<\/jats:p><\/jats:sec>RESULTS<\/jats:title>Postoperatively, the patient had no episodes of VF\/VT, pneumothorax, hemothorax, or Horner syndrome. With mexiletine and propranolol, she has remained largely VF\/VT free, with only one VT episode during the 2-year follow-up period.<\/jats:p><\/jats:sec>CONCLUSIONS<\/jats:title>Minimally invasive, posterior, extrapleural, T1\u20135 LCSD is safe and effective for treating congenital LQTS in children, while minimizing the risks associated with VATS.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.11.peds19424","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T22:04:08Z","timestamp":1581113048000},"page":"439-444","source":"Crossref","is-referenced-by-count":0,"title":["Sympathectomy via a posterior approach after a failed trans-thoracic approach: a case of its use for arrhythmia"],"prefix":"10.3171","volume":"25","author":[{"given":"Daniel","family":"Blatt","sequence":"first","affiliation":[{"name":"School of Medicine, Oregon Health & Science University, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry","family":"Cheaney","sequence":"additional","affiliation":[{"name":"School of Medicine, Oregon Health & Science University, Portland, Oregon;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Holste","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seshadri","family":"Balaji","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed M.","family":"Raslan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Ann Thorac Surg","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.1016\/j.athoracsur.2008.07.006","article-title":"Video-assisted thoracoscopic cardiac denervation: a potential novel therapeutic option for children with intractable ventricular arrhythmias","volume":"86","author":"Atallah J","year":"2008","unstructured":"Atallah J, Fynn-Thompson F, Cecchin F, DiBardino DJ, Walsh EP, Berul CI: Video-assisted thoracoscopic cardiac denervation: a potential novel therapeutic option for children with intractable ventricular arrhythmias. 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