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Updated: Jul 17, 2026
06:08
A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Video-assisted thoracoscopic sympathectomy for severe intractable angina
S S Khogali1, M Miller, P B Rajesh
1Department of Cardiology, Heartlands Hospital, Birmingham, UK. saib.khogali@paediatncs.ox.ac.uk
Summary
Video assisted thoracoscopic sympathectomy (VATS) effectively reduced angina symptoms and improved exercise tolerance in patients with advanced coronary disease. This minimally invasive procedure enhanced quality of life for these individuals.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Minimally Invasive Procedures
Background:
- Endoscopic thoracic sympathectomy is established for hyperhidrosis.
- Potential application in intractable angina and advanced coronary disease.
- Video assisted thoracoscopic sympathectomy (VATS) evaluated for symptom improvement.
Purpose of the Study:
- To evaluate VATS for symptom relief and quality of life improvement.
- In patients with intractable angina and advanced coronary disease.
- Unsuitable for traditional revascularization procedures like coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA).
Main Methods:
- VATS performed under general anesthesia with single lung ventilation.
- Extensive thoracic sympathectomy targeting second to fourth ganglia bilaterally.
- Minimally invasive approach using three stab incisions.
Main Results:
- 10 patients underwent VATS; 9 with prior CABG, 1 with diffuse coronary disease.
- Significant reduction in angina frequency and intensity observed.
- Increased exercise tolerance and time to angina onset post-VATS, sustained at 1 year.
Conclusions:
- VATS effectively reduces angina symptoms and increases exercise capacity.
- Improved quality of life was a notable outcome.
- VATS offers a viable option for select patients with refractory angina.
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