Al-Ghamdi Bandar
Heart Centre, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Saudi Arabia.
Alfaisal University, Riyadh, Saudi Arabia.
Case Rep Cardiol. 2019 Feb 5;2019:3907190. doi: 10.1155/2019/3907190. eCollection 2019.
Patients with complex congenital heart disease (CHD) and low left ventricular ejection fraction are at an increased risk of sudden cardiac death (SCD). Prevention of SCD by subcutaneous implantable cardioverter defibrillator (S-ICD) implantation may represent a valuable option in certain CHD patients. Patients with CHD and dextrocardia pose a challenge in S-ICD system implantation, and nonstandard device placement may be required. Furthermore, electrocardiogram (ECG) screening prior to S-ICD implantation in CHD patients has significant limitations. This case represents the placement of a S-ICD system on the right side of the chest in a 26-year-old male with severe biventricular failure and nonsustained ventricular tachycardia following multiple corrective surgeries of situs inversus totalis, double-outlet right ventricle with a ventricular septal defect, and pulmonary atresia. The use of S-ICDs in a CHD population and in particular CHD patients with dextrocardia and right-sided S-ICD implantation is briefly discussed.
患有复杂先天性心脏病（CHD）且左心室射血分数较低的患者发生心源性猝死（SCD）的风险增加。通过植入皮下植入式心律转复除颤器（S-ICD）来预防SCD可能是某些CHD患者的一个有价值的选择。患有CHD和右位心的患者在植入S-ICD系统时面临挑战，可能需要非标准的设备放置。此外，在CHD患者中植入S-ICD之前进行心电图（ECG）筛查存在显著局限性。本病例展示了在一名26岁男性患者的胸部右侧植入S-ICD系统的过程，该患者患有严重的双心室衰竭且在完全性内脏反位、室间隔缺损的双出口右心室和肺动脉闭锁的多次矫正手术后出现非持续性室性心动过速。本文简要讨论了S-ICD在CHD人群中的应用，特别是在患有右位心的CHD患者和右侧植入S-ICD的情况。
