New Technique for Surgical Epicardial Implantation of a Cardioverter-Defibrillator in Children and Adults With Congenital Heart Disease

Abstract

We assessed a surgical technique for implanting a cardioverter-defibrillator. The indications for cardioverter-defibrillator implantation in pediatric patients and adults with congenital heart disease are relatively specific and require multidisciplinary discussion regarding implantation modalities. We coupled the positioning of two coils sutured to the pericardium with an implantable cardioverter-defibrillator device inserted within a supradiaphragmatic pocket in a population of children and adults with congenital heart disease. Thirteen consecutive patients, either children or adults with congenital heart disease, underwent the implantation of a single-chamber implantable cardioverter-defibrillator in our center. All patients were systematically followed at 3, 6, and 12 months after implantation. Patients were mainly male (n= 9, 69%), and mean age was 21 ± 12 years. Median follow-up was 13 months. All patients underwent surgery without acute complication. One patient needed a second surgery because of defibrillation coils fracture. Neither infectious complication nor inappropriate shock was noted. There were two appropriate shocks in 1 patient. This new technique for surgical epicardial implantation of a cardioverter-defibrillator in children and adults with congenital heart disease is safe and feasible. These results should be confirmed by prospective studies with long-term follow-up.