Median sternotomy for implantable cardioverter/defibrillator

The automatic implantable cardioverter/defibrillator is an accepted mode of therapy for medically refractory sustained ventricular tachycardia or fibrillation. At the Loyola University Medical Center, Maywood, Ill, 39 implantations were performed in a 14-month period. The method of implantation was the median sternotomy. Our population included 9 patients in whom sternotomies had to be redone and 17 patients with concomitant revascularization. Two patients died due to pump failure, and one major complication (infection) occurred that was directly related to the automatic implantable cardioverter/defibrillator. The median sternotomy, because of good results, continues to be our method of choice for insertion of the automatic implantable cardioverter/defibrillator.