Minimally Invasive Bilateral Stellate Ganglionectomy for Refractory Ventricular Tachycardia.

Cardiac sympathetic denervation (CSD) for refractory ventricular tachycardia (VT) has been shown to decrease VT recurrence and defibrillator shocks in patients with ischemic and nonischemic cardiomyopathy. Here and in the accompanying Video, we demonstrate the technique for minimally invasive CSD, highlight important technical points, and report surgical outcomes. CSD is accomplished through bilateral resection of the inferior one-third to one-half of the stellate ganglion en bloc with T2-T4 sympathectomy. Despite the high potential for perioperative risk, most patients do not have serious complications. We find that surgical CSD can be performed safely in an attempt to liberate patients from refractory VT.
Competing Interests: Funding Support and Author Disclosures Dr. Lee discloses a financial relationship with AstraZeneca, Bristol Myers Squibb, and Genentech. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2021 The Society of Thoracic Surgeons and the American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)