Background Ventricular tachycardia (VT) can be a challenging problem in patients following durable left ventricular device (LVAD) implantation, and can lead to significant morbidity and mortality. Both the etiology and management of VT in this population can also vary substantially. Case presentation We herein report a case of a patient with preoperative VT who developed a drug resistant VT storm postoperatively that was ultimately controlled durably with a bedside stellate ganglion block. Conclusion This case illustrates that stellate ganglion block can be an effective and durable intervention for terminating refractory VT in LVAD patients. This method is attractive because it can be performed at the bedside in relatively unstable patients, and is less invasive than other alternatives such as VT ablation and thoracic sympathectomy.

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Central MessageOne must choose the anatomic resection that limits morbidity while limiting hospital cost and days spent in the hospital. With these outcomes being equal, one should choose the simplest option.

Current guidelines for mechanical aortic valves suggest that patients should receive lifelong anticoagulation after implantation to prevent thromboembolic events. There are currently very few studies that explore patient outcomes without anticoagulation after mechanical aortic valve placement. We herein present a case of a patient who had stopped taking warfarin 2 years after having a mechanical aortic valve replacement, yet had no thromboembolic events or mechanical failure for 24 years.