Key result
Careful anesthetic management, including one-lung ventilation and avoidance of QT-prolonging drugs, resulted in a successful left thoracoscopic sympathectomy without adverse cardiac events in a 5-year-old child with Long QT syndrome.
Why the study?
Reduced repolarisation reserve in LQTS can be unmasked by perioperative factors, creating challenges in isolating the lung while preventing torsadogenic potential.
Case Report (n=1)
Highlights the challenges and management strategies for anaesthesia during left thoracoscopic sympathectomy in a pediatric patient with Long QT syndrome and an epicardial pacemaker.
Long QT syndrome (LQTS) is a myocardial repolarisation disorder caused by cardiac ion channelopathy and one of its common presentations is recurrent syncope. This reduced repolarisation reserve in LQTS can be unmasked by perioperative factors like electrolyte imbalance, drugs, hypothermia and changes in cardiac autonomic tone. We report the anaesthetic management of left thoracoscopic sympathectomy in a 5-year-old child with LQTS and epicardial pacemaker in situ. It is very challenging to isolate the lung on one hand and prevent the predisposition to torsadogenic potential on the other.
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Subramaniam et al. (2019) conducted a case report in Long QT syndrome (n=1). Anesthetic management for left thoracoscopic sympathectomy was evaluated on Perioperative adverse cardiac events. Careful anesthetic management, including one-lung ventilation and avoidance of QT-prolonging drugs, resulted in a successful left thoracoscopic sympathectomy without adverse cardiac events in a 5-year-old child with Long QT syndrome.
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