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The Annals of Thoracic Surgery, Vol 47, 780-781, Copyright © 1989 by The Society of Thoracic Surgeons

ARTICLES

Right mini-thoracotomy: an adjunct to left subcostal automatic implantable cardioverter defibrillator implantation

GM Lawrie, RR Kaushik and A Pacifico
Cora and Webb Mading Department of Surgery and Medicine (Cardiology), Baylor College of Medicine, Houston, Texas 77030.

High defibrillation thresholds are encountered in some patients during implantation of the automatic implantable cardioverter defibrillator (AICD). In a consecutive series of 52 patients with AICD implants, 46 had allepicardial implants by left subcostal thoracotomy, and 8 of these patients had thresholds greater than 30 J. Placement of an apicolateral large left ventricular patch and an extrapericardial large right atrial patch electrode through a limited right thoracotomy produced substantial reduction in their thresholds. Especially in patients who have had previous intrapericardial operations, this technique provides a simple solution to the problem of high thresholds.




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Copyright © 1989 by The Society of Thoracic Surgeons.