Case Report

Right-Sided Subcutaneous Implantable Cardioverter Defibrillator System Implantation in a Patient with Complex Congenital Heart Disease and Dextrocardia: A Case Report and Literature Review

Table 1

Comparison of the reported cases with right-sided S-ICD implantation and current case.

Study year, authorDiagnosesSurgeries/proceduresReason to implant S-ICDDeviceFollow-up

2015, Waller et al. [13]A 31-year-old female with TGA, situs inversus with dextrocardia
Out-of-hospital VF arrest
Mustard procedure aged 18 months
Transvenous dual chamber pacemaker in situ for bradycardia
Atrial lead revision due to failure to capture of the original lead
Potential risk of baffle stenosis and superior vena cava obstruction with transvenous systemBoston Scientific SQ-RX S-ICD

2014, Ceresnak et al. [14]A 21-year-old man with a history of dextrocardia, TOF, and Klinefelter syndromeMultiple cardiac surgeries including placement of a right modified BT shunt in the newborn period, complete repair of TOF at age 1 year, PV replacement with intraoperative cryoablation of the RV/RVOT due to VT, TV annuloplasty, and modified RA maze procedure because of recurrent atrial flutterEpicardial ICD system could be not implanted due to abdominal compartment syndrome and recurrent fever and the concern for infectionBoston Scientific SQ-RX S-ICD
History of VT and easily inducible VF in the EPS.Left-sided transvenous ICD at the of age 14 years with placement of a subcutaneous coil due to failed DFT
Repeat PV replacement, TV replacement for severe TR and PR, RVOT patch augmentation, and partial removal of the transvenous ICD system

Current caseA 26-year-old male situs inversus totalis, double-outlet RV with a VSD, and pulmonary atresia (a type of TOF).
Severe biventricular dysfunction, on the waiting list for heart transplantation
Nonsustained VT
Multiple corrective surgeries including biventricular repair in 1993 and TV repair, residual VSD closure, and RV to PA homograft in 1997 redo replacement of the PV utilizing a cryopreserved pulmonary homograft due to dysfunctional pulmonary homograft in 2010A small residual VSDBoston Scientific Emblem A209 S-ICD22 months

BT: Blalock–Taussig; DFT: defibrillation threshold testing; EPS: electrophysiology study; ICD: implantable cardioverter defibrillator; PA: pulmonary artery; PR: pulmonary regurgitation; PV: pulmonary valve; RA: right atrial; RV: right ventricle; RVOT: right ventricular outflow tract; S-ICD: subcutaneous implantable cardioverter defibrillator; TOF: tetralogy of Fallot; TGA: transposition of the great arteries; TV: tricuspid valve; VF: ventricular fibrillation; VSD: ventricular septal defect; VT: ventricular.