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The Annals of Thoracic Surgery, Vol 54, 791-793, Copyright © 1992 by The Society of Thoracic Surgeons

ARTICLES

Bilateral anterior thoracotomy for automatic implantable cardioverter defibrillator placement in patients with previous sternotomy

SV Karwande and JR Rowles
Department of Surgery, University of Utah Medical Center, Salt Lake City 84132.

Bilateral anterior thoracotomy, extrapericardial patches, and endocardial sensing lead placement have been used in 40 patients with previous sternotomy. The mean defibrillation threshold was 15 J, and in all patients the defibrillation threshold was less than 20 J. The surgical procedure is simplified with less risk by avoiding dissection of previously operated regions. Serious pulmonary complications have been avoided by adequate pain control with epidural analgesia and early mobilization. This technique has successfully been used in patients with underlying chronic obstructive pulmonary disease and amiodarone- induced pulmonary fibrosis. All patients have been extubated by the first postoperative day.




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Copyright © 1992 by The Society of Thoracic Surgeons.