Epicardial Implantable Cardioverter-Defibrillator in a 2-Month-Old Infant Koichi Sughimoto, MD, PhD, Yuta Tsuchida, MD, Hidenori Hayashi, MD, Shinzo Torii,

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Epicardial Implantable Cardioverter-Defibrillator in a 2-Month-Old Infant Koichi Sughimoto, MD, PhD, Yuta Tsuchida, MD, Hidenori Hayashi, MD, Shinzo Torii, MD, PhD, Tadashi Kitamura, MD, PhD, Tetsuya Horai, MD, PhD, Kagami Miyaji, MD, PhD The Annals of Thoracic Surgery Volume 103, Issue 3, Pages e263-e265 (March 2017) DOI: 10.1016/j.athoracsur.2016.08.040 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Right angled-forceps grab the tip of the coil lead covered with a silicone elastomer cap. The same maneuvers were repeated 4 times (Numbers 1-4 indicate the order of the procedure from the bottom to the top using the forceps.). (B) Placement of the coil lead and pacing leads. The tip of the coil lead was wrapped with a sheet of GoreTex. A myocardial biopsy was performed from the avascular area. The Annals of Thoracic Surgery 2017 103, e263-e265DOI: (10.1016/j.athoracsur.2016.08.040) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Incision lines and location of the pocket. (B) Axial transection view of the anatomic image of the incision site, including the muscles (Green arrow indicates the site of the skin incision.). (C) Storing the implantable cardioverter defibrillator in the pocket. (EOA = external oblique abdominal muscle; IOA = internal oblique abdominal muscle; RA = rectus abdominal muscle; TA = transverse abdominal muscle.) The Annals of Thoracic Surgery 2017 103, e263-e265DOI: (10.1016/j.athoracsur.2016.08.040) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Roentgenogram of the Chest and abdominal X ray after the implantation of an ICD and leads. The Annals of Thoracic Surgery 2017 103, e263-e265DOI: (10.1016/j.athoracsur.2016.08.040) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions