Successful implantation of S-ICD using the intermuscular two-incision technique in a patient with severe pectus excavatum.

A patient with severe pectus excavatum, dilated ischemic heart disease, and indication for defibrillator implantation for primary prevention of sudden death underwent successful ultrasound-guided serratus anterior plane block and parasternal block with intermuscular two-incision technique implantation with no complications. At follow-up, all the parameters resulted stable with excellent signal sensing.