Migration and percutaneous implantation of a second aortic prosthesis.

with complex heart diseases and alternative approaches: a) implantation of 1 to 3 subcutaneous electrodes as the high-energy electrode or the transvenous defibrillation electrode itself in a subcutaneous position; b) transatrial approach with implantation of the defibrillation electrode directly through the right atrium; and c) implantation of the defibrillation electrode in the pericardial sac. Given the small number of patients and the limited followup, it is hard to predict the complications associated with these procedures in the medium term. Stephenson et al proposed annual monitoring of the defibrillation thresholds, which can become fundamentally elevated with subcutaneous electrodes. Cannon et al recommend performing an annual echocardiography when there are electrodes in the pericardial sac to detect the possibility of progressive strangulation of the myocardium. This technique is considered preferable in patients with larger body surface areas, as was the case in our patient. Due to the increase in the population with congenital heart disease reaching adulthood, we will need to use this and other approaches increasingly often.