Simultaneous repair of congenital heart defects and pectus excavatum in young children

Pediatr Surg Int. 2018 Mar;34(3):269-275. doi: 10.1007/s00383-017-4223-z. Epub 2018 Jan 5.

Abstract

Purpose: The present study was undertaken to summarize our experience with the concurrent repair of pectus excavatum (PE) and congenital heart defects in young children over the past 15 years.

Methods: A retrospective study was conducted that included patients who underwent combined repair of PE and a congenital heart defect in a large clinical center between 2002 and 2017. Intraoperative and postoperative patient characteristics, postoperative complications and surgical outcomes were recorded.

Results: Twenty-one patients met the inclusion criteria. An open heart surgery and a modified sternal elevation with anterior sternal suspension were performed. No intraoperative complications occurred. Postoperatively, three patients developed pneumonia, two patients developed subcutaneous effusions, one patient sustained an asymptomatic pneumothorax, and one other patient had a transitory fever. In all cases, postoperative recovery was uneventful, and no perioperative mortality occurred. Bar removal was performed in 19 patients at an average of 2.55 years postoperatively: 18 of them achieved an excellent outcome, and 1 patient had a good final result.

Conclusion: A combined procedure of modified sternal elevation and cardiac repair may be performed safely in young children. Early repair of PE is feasible and effective in these patients.

Keywords: Children; Congenital heart defect; Pectus excavatum; Simultaneous repair; Sternal elevation.

MeSH terms

  • Cardiac Surgical Procedures
  • Child, Preschool
  • Female
  • Funnel Chest / surgery*
  • Heart Defects, Congenital / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Postoperative Complications
  • Retrospective Studies
  • Sternum / surgery