Journal article
Implantation of cardioverter defibrillators in the post-sternotomy patient
The Annals of thoracic surgery, v 53(6), pp 978-983
01 Jun 1992
PMID: 1596159
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
In an attempt to minimize the hazards of redo stemotomy or thoracotomy in patients who have undergone previous cardiac procedures, a technique has been developed for cardioverter dcfibrillator implantation that involves dissection through a left subcostal incision and placement of extrapericardial defibrillation patches. This approach was used in 22 consecutive patients who required an implantable cardioverter defibrillator 4 to 156 months after previous median sternotomy. Defibrillation threshold energy was less than or equal to 20 J in every patient. Ninety-one percent of patients were extubated during the first 24 hours and were transferred out of the intensive care unit by the second postoperative day. One patient died of an acute myocardial infarction 3 days postoperatively (
1
/
22
, 4.5%). It was necessary to replace one lead for mechanical failure of an adapter, one patch required repositioning, and 1 patient needed drainage of a persistent pleural effusion (
3
/
22
, 13.6%). No further complications occurred during 3 to 27 months of followup. Advantages of the subcostal approach included prompt extubation, a single incision, and minimal morbidity. This approach is safe and effective, and is the method of choice for implantation of a cardioverter defibrillator in patients who have undergone prior sternotomy.
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Details
- Title
- Implantation of cardioverter defibrillators in the post-sternotomy patient
- Creators
- Ralph J. Damiano - Virginia Commonwealth University Medical CenterAndrew H. Foster - Virginia Commonwealth University Medical CenterKenneth A. Ellenbogen - Virginia Commonwealth University Medical CenterMark A. Wood - Virginia Commonwealth University Medical CenterBruce S. Stambler - Virginia Commonwealth University Medical CenterWilliam J. Welch - Virginia Commonwealth University Medical CenterAndrew S. Wechsler - Virginia Commonwealth University Medical Center
- Publication Details
- The Annals of thoracic surgery, v 53(6), pp 978-983
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; [Retired Faculty]
- Web of Science ID
- WOS:A1992HX17700006
- Scopus ID
- 2-s2.0-0026638777
- Other Identifier
- 991020705437904721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery