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Ann Thorac Surg 1995;59:764-767
© 1995 The Society of Thoracic Surgeons

How To Do It

Technique for Implantation of Cardioverter Defibrillators in the Subpectoral Position

Andrew H. Foster, MD

Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland

Accepted for publication November 1, 1994.

The downsized cardioverter defibrillators in early clinical trials in the United States are smaller and lighter than approved cardioverter defibrillators, but they remain relatively bulky. Prepectoral implantation of these devices may increase the risk of erosion, particularly in those patients with cardiac cachexia. This report describes a versatile technique for submuscular pectoral cardioverter defibrillator implantation using a lateral approach to the subpectoral space that has been used in 6 patients. Alternative surgical approaches for pectoral cardioverter defibrillator implantation and potential problems with these techniques are discussed.




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