This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Brigitte R. Osswald Ursula Tochtermann Ahmed Tanzeem Siegfried Hagl Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Osswald, B. R. Articles by Hagl, S. Search for Related Content PubMed PubMed Citation Articles by Osswald, B. R. Articles by Hagl, S. Related Collections Cardiac - other Electrophysiology - arrhythmias Minimally invasive surgery

Minimal touch surgical implantable cardioverter defibrillator implantations

Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany

*Corresponding author. Tel.: +49 6221 56 6111; fax: +49 6221 56 4046.

E-mail address: brigitte_osswald{at}med.uni-heidelberg.de (B.R. Osswald).

A growing number of patients with contraindication for transvenous implantable cardioverter defibrillator (ICD) implantation or need for system upgrade of a pre-existent pacemaker system is to be observed. Therefore, unconventional system constellation may be necessary to provide patient safety by using a minimal invasive access avoiding sternotomy. Two similar cases are presented to demonstrate configuration solutions which can be easily individually modified. Simple pacemaker and ICD implantation is nowadays mostly performed by cardiologists and/or general surgeons. As soon as partial or total thoracotomy becomes necessary, the patient will be referred to a department of cardiac surgery. Hence, in the very near future, cardiac surgeons will face a large number of redo procedures for pacemaker- and ICD systems including the necessity for mixed transvenous and epicardial solutions. To avoid significant morbidity deriving from sternotomy and pericardiotomy, concepts for as less invasive as possible solutions are presented.

Key Words: Pacemaker; Implantable cardioverter defibrillator; Implantation technique; Lead placement; Education