Ischemic skin necrosis due to the pressure of the ICD generator on the overlying skin is an infrequent but potential complication with ICD therapy. This report describes a case of a patient with an ICD implantation who developed impending ischemic skin necrosis over the generator site on the abdominal wall. The skin lesion was cured by replacement of the ICD with a smaller model and insertion beneath the rectus muscle. Ischemic skin necrosis should be a potential concern when internal devices are confined to relatively small anatomic places. There is a rapidly expanding patient population that receives ICD and the possibility of prophylactic use of the ICD may further increase the number of recipients.
Early complications are generally related to the surgical procedure.
Late complications include delivery of inappropriate shocks and component failure. The clinical presentation of infection can vary widely and may be difficult to diagnose. We herein report a case of ischemic skin necrosis over the abdomen at the site of ICD generator implantation in a 69 year old man. A 69 year old male with a history of hypertension and diabetes mellitus, underwent coronary artery bypass surgery for a multivessel coronary artery disease and a bioprosthetic aortic valve replacement for aortic stenosis in 1983. In 1993, the patient underwent a repeat aortic valve replacement with a bioprosthetic valve.