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Case Reports
. 2024 Feb 5;29(5):102231.
doi: 10.1016/j.jaccas.2024.102231. eCollection 2024 Mar 6.

S-ICD Implantation in Secondary Prevention in a Young Patient With Recent Surgically Repaired Pectus Excavatum

Luca Checchi  1 , Laura Perrotta  1 , Giuseppe Ricciardi  1 , Andrea Colella  1 , Gabriele Bambagioni  1 , Davide Ciliberti  2 , Valentina Bogini  2 , Alessandro Gonfiotti  3 , Iacopo Olivotto  4 , Paolo Pieragnoli  1
Affiliations
Case Reports

S-ICD Implantation in Secondary Prevention in a Young Patient With Recent Surgically Repaired Pectus Excavatum

Luca Checchi et al. JACC Case Rep. .

Abstract

We report a case of successful implantation of a subcutaneous implantable cardioverter-defibrillator in a young patient with severe pectus excavatum presenting with out-of-hospital ventricular fibrillation arrest who was recently surgically repaired with a MIRPE-Nuss procedure. No complications in lead positioning were observed, and the device was tested to determine that it functioned properly.

Keywords: Nuss procedure; S-ICD; electrophysiology; pectus excavatum; right ventricle; secondary prevention; sudden cardiac arrest; ventricular fibrillation.

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Conflict of interest statement

Dr Olivotto has received consulting fees from Cytokinetics and Bristol Myers Squibb. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
ECG Tracings (A) Before ventricular fibrillation arrest. (B) Ventricular fibrillation recorded by automated external defibrillator with shock delivery. (C) Immediately after sudden cardiac arrest. (D) Electrocardiogram (ECG) during hospital stay (disappearance of negative T waves).
Figure 2
Figure 2
Diagnostic Work-Up Diagnostic work-up performed in order to rule out differential diagnosis of cardiac arrest. ARVC = arrhythmogenic right ventricular cardiomyopathy; AV = aortic valve; CA = cardiac arrest; CAD = coronary artery disease; CCI = cardiac compression index; CT = computed tomography; DCM = dilated cardiomyopathy; ECG = electrocardiograph; EF = ejection fraction; HCM = hypertrophic cardiomyopathy; LGE = late gadolinium enhancement; LV = left ventricular; MAD = mitro-annular disjunction; MRI = magnetic resonance imaging; MVP = mitral valve prolapse; RV = right ventricle/ventricular; SR = sinus rhythm; TTE = transthoracic echocardiography; VF = ventricular fibrillation.
Figure 3
Figure 3
Cardiac CT Scans Significant RV compression at different levels. Abbreviations as in Figure 2.
Figure 4
Figure 4
HI and CCI Measured at MRI MRI measurements: HI = 5; CCI = 2.30. HI = Haller index; other abbreviations as in Figure 2.
Figure 5
Figure 5
Chest Radiography (A) Postero-anterior and (B) Latero-lateral projections showing the metal bars inserted with Nuss procedure. (C) After subcutaneous implantable cardioverter-defibrillator implantation.
See this image and copyright information in PMC

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