Bilateral Upper Thoracic Sympathectomy in Angina Pectoris: Results in 52 Cases

Beta-adrenergic blockade in angina pectoris: a method of treadmill assessment.

“…The beneficial action of these drugs is likely to be due to their blockade of 83-adrenergia activity. A similar effect follows bilateral upper thoracic sympathectomy, and we have shown (Apthorp et al, 1964;Birkett et al, 1965) that there is some correlation between the improvement obtained in a patient after pronethalol or propranolol and the greater improvement which usually follows operation. The mechanism of action is complex: sympathectomy and /-adrenergic blockade cause slowing of the heart-rate and also a reduction in contractility, resulting in increased heart-size, increased filling-pressure, increased duration of systolic ejection, and often some decrease in cardiac output.…”

“…The effects of /3-adrenergic blockade on seven of the present series have been briefly reported previously and compared with the results achieved by bilateral upper thoracic sympathectomy (Birkett et al, 1965).…”

Experience with Coeliac Axis Compression Syndrome

“…It is perhaps relevant that the two patients who became asymptomatic in the present series had a more ex-4 13 tensive clearance of the coeliac axis-aortic junction, the one 6 12 in an assessment for direct arterial surgery, the other because of bleeding from an inferior phrenic artery that took origin trom tne coellac. 'Inere is a possible parallel otr reclie u visceral pain by autonomic neurectomy in the treatment of angina pectoris by upper thoracic sympathectomy (White and Bland, 1948;Lindgren, 1950;Burnett and Evans, 1956;Palumbo and Lulu, 1963;Birkett et al, 1965). Marable et al (1968), who have the 'argest series of cases (30), suggest that the best results are to be expected in young women with postprandial epigastric pain as the dominant symptom, and it was for this reason that volunteers studied were in the younger age group.…”

Results of endoscopic thoracic sympathectomy (ETS) on hyperhidrosis, facial blushing, angina pectoris, vascular disorders and pain syndromes of the hand and arm

“…Open sympathectomy has been used to treat angina pectoris since 1921 [26]. Larger series were published in the mid 1900s [3,41]. We have used ETS for patients unsuitable for conventional coronary surgery.…”