title: Nontraditional placement of an implantable cardioverter-defibrillator in a heterotaxy patient after the completion of total cavopulmonary connection.
abstract: A 15-year-old boy with heterotaxy syndrome developed a prolonged QT interval and intractable torsade de pointes after the administration of sodium channel blockers for atrial tachyarrhythmia. Although this situation called for the placement of an implantable cardioverter-defibrillator, a conventional transvenous approach was not available since the patient had previously undergone a nonfenestrated extracardiac total cavopulmonary connection. We were urged to carry out the surgical placement of an epicardial lead for an implantable cardioverter-defibrillator using a single coil transvenous shock lead through re-do midline sternotomy. Here we describe the details of this nontraditional surgical procedure for the placement of a lead for an implantable cardioverter-defibrillator in a case without venous access into the heart.
authors.affiliation: Department of Cardiovascular Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8577, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Tsukada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatsu
authors.forename: Shinya
authors.initials: S
authors.lastname: Kanemoto
authors.forename: Lisheng
authors.initials: L
authors.lastname: Lin
authors.forename: Miho
authors.initials: M
authors.lastname: Takahashi-Igari
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Horigome
authors.forename: Shonosuke
authors.initials: S
authors.lastname: Matsushita
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Sakakibara
mesh_terms: D000293:Adolescent; D017147:Defibrillators, Implantable; D018610:Heart Bypass, Right; D059446:Heterotaxy Syndrome / Q000150:complications*; D006801:Humans; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods*; D016171:Torsades de Pointes / Q000209:etiology / Q000601:surgery*