Perioperative management of thoracoscopic left cardiac sympathetic denervation for refractory long QT syndrome: a case report

Figures

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  Fig. 1. Stellate ganglion block transiently shortened corrected QT interval. Panels (a) and (b) show the electrocardiograms before and after the block, respectively. The red bidirectional arrows denote the duration of the corrected QT intervals. HR, heart rate; QTc, corrected QT interval

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  Fig. 2. Anesthesia record of the present case. The LCSD procedure was completed without the occurrence of arrhythmias and without the need for the use of vasopressors, inotropic agents or mechanical circulatory support. sBP, systolic blood pressure; dBP, diastolic blood pressure, SpO2, percutaneous oxygen saturation; ICD, implantable cardioverter-defibrillators; FA, femoral artery; FV, femoral vein; TPVB, thoracic paravertebral block; Spon, spontaneous respiration; PCV, pressure controlled ventilation; OLV, one lung ventilation; ✕, start and end of anesthesia; ◎, start and end of surgery; I, tracheal intubation; E, tracheal extubation

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  Fig. 3. Schematic illustration of thoracoscopic LCSD. Following pleural incision over the sympathetic ganglia at the levels of the second, third, and fourth ribs, the exposed ganglia were cauterized, dissected, and resected. The pink-shaded rectangle indicates the extent of resected sympathetic ganglia. This illustration was created by Editage based on the original draft prepared by AN and YT. G, ganglion