Key result
Subpectoral ICD placement in women preserves breast symmetry with ~10% complication rate at 12 months.
Why the study?
The usual subclavian placement of ICDs causes visible device and scarring leading to aesthetic deformity and psychosocial distress, especially in young women.
Observational (n=30)
Answers are grounded in this paper and cite their sources.
May support subpectoral ICD placement for cosmesis in women; hypothesis-generating and requires validation in larger prospective studies.
The implantable cardioverter defibrillator (ICD) is the treatment of choice for life-threatening arrhythmias. Usually, the device is placed, by a subclavian access, on the upper portion of the pectoralis major muscle. As a result, the visibility of the device and the wide subclavian scar create an important aesthetic deformity, especially in young women, evolving in a relevant psychosocial distress. The authors report their experience with subpectoral ICD implantation. Between January 2001 and December 2011, approximately 30 consecutive female patients underwent submuscular ICD implantation or substitution, performed in collaboration with the cardiology team. No significant complications, except 1 case of wound dehiscence and 2 cases of caudal dislocation of the device, were observed. At 6 and 12 months' follow-up, no significant difference between preoperative and postoperative breast symmetry and volume was noticed. The combined approach aims at reducing the visible signs of the procedure and improving the psychological outcomes.
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Persichetti et al. (2012) conducted an observational in Life-threatening arrhythmias requiring implantable cardioverter defibrillators (n=30). Subpectoral/submuscular ICD implantation was evaluated on Complications, and postoperative breast symmetry and volume. Subpectoral implantable cardioverter defibrillator placement in 30 women resulted in 3 complications (1 wound dehiscence, 2 dislocations) and preserved breast symmetry and volume at 12 months.
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