Korean Circ J.  2016 Sep;46(5):734-738. 10.4070/kcj.2016.46.5.734.

Combined Subpectoral Implantation of Implantable Cardioverter-Defibrillator and Augmentation Mammoplasty in a Young Female Patient

• Kim DJ
• Uhm JS
• Park JW
• Youn JC
• Lee DW
• Koo BN
• Lee MH

• KMID: 2389634
• DOI: http://doi.org/10.4070/kcj.2016.46.5.734

Abstract

Subcutaneous implantation of a cardiac implantable electronic device is the standard method. Occasionally, subpectoral cardiac implantable electronic device (CIED) implantation via axillary incisions is performed in young female patients for cosmetic purposes. Because subpectoral CIED implantation and augmentation mammoplasty involve the same layer, it is feasible to perform both procedures simultaneously. We report a case of combined subpectoral implantation of an implantable cardioverter-defibrillator and augmentation mammoplasty via the axillary approach in a young female patient with dilated cardiomyopathy and small breasts.

Keyword

Implantable cardioverter-defibrillator; Young adult; Female; Mammoplasty; Pectoralis muscles

MeSH Terms

Breast
Cardiomyopathy, Dilated
Defibrillators, Implantable*
Female
Female*
Humans
Mammaplasty*
Methods
Pectoralis Muscles
Young Adult

Figure

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  Fig. 1 M-mode of the left ventricle. (A) Left ventricular end-diastolic diameter: 66 mm, (B) left ventricular end-systolic diameter: 57 mm. Ejection fraction by M-mode: 20%.

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  Fig. 2 Non-sustained monomorphic ventricular tachycardia detected by 24 h electrocardiogram monitoring.

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  Fig. 3 Placement and fixation of the implantable cardioverter-defibrillator leads through the axillary incision in the surgical field.

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  Fig. 4 Chest radiography, posteroanterior (A) and left lateral (B) views after combined subpectoral implantation of an implantable cardioverter-defibrillator and augmentation mammoplasty.

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  Fig. 5 Clinical photographs before (A) and after (B) the combined subpectoral implantable cardioverter-defibrillator implantation and augmentation mammoplasty procedure. Right breast volume increased from 45 to 163 mL and left breast volume from 56 to 169 mL. There is neither a visible scar nor protrusion on the chest.

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  Fig. 6 Types of cosmetic cardiac implantable electronic device implantation. (A) Axillary-axillary-subpectoral implantation. (B) Axillary-inframammary-submammary implantation. (C) Infraclavicular-axillary-subpectoral implantation. (D) Infraclavicular-inframammary-submammary implantation.

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