Pectus excavatum and cardiac surgery: simultaneous correction advocated

Thorac Cardiovasc Surg. 2014 Apr;62(3):238-44. doi: 10.1055/s-0034-1367737. Epub 2014 Feb 7.

Abstract

Background: Severe pectus excavatum may be present in combination with cardiac conditions requiring open-heart surgery. The best strategy for this situation has been debated controversially.

Patients and methods: In a retrospective study, we analyzed all our patients undergoing concurrent pectus excavatum correction and open-heart surgery.

Results: Ten patients aged 9 to 70 years underwent a simultaneous combined surgical procedure between 2001 and 2013. Indications for cardiac surgery were various forms of congenital and acquired heart disease including coronary artery disease with internal thoracic artery grafts and ascending aortic aneurysms. A modified Ravitch procedure was performed for pectus excavatum correction (mean Haller-Index 5.0). Mean operating time was 364 (210-495) minutes and mean duration of cardiopulmonary bypass was 125 (54-222) minutes. All procedures were completed successfully. Postoperatively minor complications were observed in three patients. In-hospital and 30-day mortalities were nil. Good cosmetic and functional results were achieved in all patients.

Conclusions: Our data demonstrate that simultaneous pectus excavatum correction and cardiac surgery is effective and reliable. A combined approach is advocated if candidates for cardiac surgery present with significant pectus excavatum deformity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiopulmonary Bypass
  • Child
  • Feasibility Studies
  • Female
  • Funnel Chest / complications
  • Funnel Chest / diagnosis
  • Funnel Chest / surgery*
  • Heart Diseases / complications
  • Heart Diseases / diagnosis
  • Heart Diseases / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Orthopedic Procedures* / adverse effects
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome