To the best our knowledge, this is the first study demonstrating subcostal ICD placement in young adults and resulting in equivalent to better outcomes when compared with conventionally placed pectoral ICD. Subcostal ICD placement might be considered an alternative option in young adults as it results in better procedural outcomes and also comparable rate of adverse events during follow-up, but bigger studies with a larger number of patients are needed for a definitive conclusion.
We present the case of a 61-year-old man with a history of pacemaker implantation 15 years ago. The patient was admitted with chronic swelling of the right hemithorax and inflammation of the old incision scar after the replacement of pacemaker generator 6 years ago. The patient also presented symptoms and clinical signs of superior vena cava syndrome. Computed tomography of the thorax showed obstruction of the superior vena cava. The surgical procedure consisted of extraction of infected pacemaker system with excimer laser technique followed by dilatation and stenting of the SVC and finally implantation of a new permanent pacemaker system on the left side.
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