Clinical experience of repair of pectus excavatum and carinatum deformities

Cardiovasc J Afr. 2013 Sep;24(8):318-21. doi: 10.5830/CVJA-2013-065.

Abstract

Objective: We present the results of surgical correction of pectus excavatum (PE) and pectus carinatum (PC) deformities in adults, and also report a new method of sternal support used in surgery for PE deformities.

Methods: We present the results of 77 patients between the ages of 10 and 29 years (mean 17) with PE (n = 46) or PC (n = 31) deformities undergoing corrective surgery from 2004 to 2011, using the Ravitch repair method. Symptoms of the patients included chest pain (15%) and tachycardia (8%). Three patients underwent repair of recurrent surgical conditions.

Results: All of the patients with dyspnoea with exercise experienced marked improvement at five months post operation. Complications included pneumothorax in 5.1% (n = 4), haemothorax in 2.6% (n = 2), chest discomfort in 57% (n = 44), pleural effusion in 2.6% (n = 2), and sternal hypertrophic scar in 27% (n = 21) of patients. Mean hospitalisation was eight days. Pain was mild and intravenous analgesics were used for a mean of four days. There were no deaths. Results after surgical correction were very good or excellent in 62 patients (80%) at a mean follow up of three years. Three patients had recurrent PE and were repaired with the Nuss procedure. In three patients who underwent the Ravitch procedure, a stainless steel bar was used for sternal support instead of Kirschner wire.

Conclusion: Pectus deformities may be repaired with no mortality, low morbidity, very good cosmetic results and improvement in cardiological and respiratory symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Bone Wires
  • Child
  • Exercise Tolerance
  • External Fixators
  • Funnel Chest / complications
  • Funnel Chest / diagnosis
  • Funnel Chest / physiopathology
  • Funnel Chest / surgery*
  • Humans
  • Length of Stay
  • Orthopedic Procedures* / adverse effects
  • Orthopedic Procedures* / instrumentation
  • Osteotomy
  • Recovery of Function
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Thoracic Wall / abnormalities
  • Thoracic Wall / diagnostic imaging
  • Thoracic Wall / surgery*
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult