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Ruptured spleen as a complication of insertion of an automatic implantable cardioverter-defibrillator
M D Dumas1, D B Bach, G M Guiraudon
1Department of Diagnostic Imaging, University Hospital, University of Western Ontario, London.
Insights
A rare complication of automatic implantable cardioverter-defibrillator (AICD) implantation via the left subcostal approach is splenic hematoma. This can lead to serious internal bleeding and requires surgical intervention like splenectomy.
Area of Science:
- Cardiovascular Surgery
- Medical Device Implantation
- Surgical Complications
Background:
- The left subcostal approach is a surgical technique used for device implantation.
- Automatic implantable cardioverter-defibrillators (AICDs) are critical for managing life-threatening arrhythmias.
Observation:
- A previously unreported complication associated with AICD insertion via the left subcostal approach was observed.
- The patient developed splenic hematoma, intraperitoneal hemorrhage, and hypotension post-implantation.
Findings:
- Splenic hematoma formation occurred within 5 days of AICD implantation.
- Intraperitoneal hemorrhage and hypotension were significant complications requiring intervention.
- The patient required a splenectomy to manage the complications.
Implications:
- This case highlights a potential risk associated with the left subcostal surgical approach for AICD implantation.
- Awareness of this complication is crucial for surgeons performing this procedure.
- Further investigation may be warranted to understand the mechanism and incidence of this complication.
Abstract:
The authors describe a previously unreported complication of insertion of an automatic implantable cardioverter-defibrillator via the left subcostal surgical approach. Splenic hematoma, intraperitoneal hemorrhage and hypotension developed in a 66-year-old man within 5 days of implantation, and the patient underwent splenectomy.