Surgical treatment and outcomes of pectus arcuatum.

Objective: Pectus arcuatum is a rare variant of pectus deformities that can cause varying degrees of cardiac compression. A review of the evaluation, surgical repair, and outcomes of pectus arcuatum is presented.

Methods: A retrospective review of all patients undergoing surgical treatment of pectus arcuatum at a single institution was conducted between January 1, 2010, and May 31, 2024.

The Complexity of Familial Inheritance in Pectus Excavatum: A Ten-Family Exome Sequencing Analysis.

: Pectus excavatum (PEx) is considered, at least partially, a familial disorder. A variety of inheritance patterns, associations with genetic syndromes, and pathogenic variants have been reported. However, the etiology of this condition is still not completely understood, and no known genes have been identified as definitive contributors.

Surgical Removal of a Migrated WATCHMAN Device.

The WATCHMAN™ atrial appendage closure device is designed to reduce the risk of stroke in patients with nonvalvular atrial fibrillation who are not suitable candidates for long-term oral anticoagulation therapy. However, the device also carries small risks, including procedural complications such as device migration, embolization, or pericardial effusion. We describe a case of WATCHMAN device migration requiring surgical retrieval.

Revision after prior failed pectus excavatum repair: higher risks and greater complications than primary surgery.

Background: Revision of a prior failed pectus excavatum (PE) repair is occasionally required. These procedures may be technically more complex and have a greater risk of complications. This study was performed to evaluate the outcomes of adult patients undergoing revision procedures.

Pectus Disorders: Excavatum, Carinatum and Arcuatum.

This article reviews pectus excavatum, carinatum, and arcuatum. Topics covered include etiology, epidemiology, associated syndromes, physiologic impact, workup, indications for treatment, surgical and nonsurgical therapy, results, complications, and emerging therapies. Pectus excavatum is an inward deformation of the sternum and/or anterior chest wall.

Does a high Haller index influence outcomes in pectus excavatum repair?

Objective: Severity for pectus excavatum includes Haller index (HI) > 3.25. An extremely high HI (≥8) may influence surgical approach and complications.

The electrocardiographic manifestations of pectus excavatum before and after surgical correction.

Background: Pectus excavatum (PEx) can cause cardiopulmonary limitations due to cardiac compression and displacement. There is limited data on electrocardiogram (ECG) alterations before and after PEx surgical repair, and ECG findings suggesting cardiopulmonary limitations have not been reported. The aim of this study is to explore ECG manifestations of PEx before and after surgery including associations with exercise capacity.

Minimally invasive repair of pectus excavatum in adults: a review article of presentation, workup, and surgical treatment.

Pectus excavatum (Pex) is one of the most common congenital deformities of the chest wall, with pectus constituting 90% of all chest wall deformities and excavatum being reported in almost 1:400 to 1:1,000 live births with predominant occurrence in males up to five times more than in females. Depending on the severity, presentation varies from mild cosmetic complaints to life limiting cardiopulmonary symptoms. Patients may develop symptoms as they age, and these symptoms may worsen over the years.

Evolution of Pain Control for Adult Pectus Excavatum Repair.

Background: Pain control after minimally invasive repair of pectus excavatum (MIRPE) can be challenging, especially in adult patients undergoing surgical repair. This study reviewed different analgesic modalities used over ≥10 years after pectus repair.

Methods: A retrospective analysis was performed of adult patients (≥18 years) who underwent uncomplicated primary MIRPE at a single institution from October 2010 to December 2021.

Erector Spinae Plane Block With Liposomal Bupivacaine: Analgesic Adjunct in Adult Pectus Surgery.

Introduction: Pain management may be challenging in patients undergoing pectus excavatum (PE) bar removal surgery. To enhance recovery, opioid sparing strategies with regional anesthesia including ultrasound-guided erector spinae plane block (ESPB) have been implemented. The purpose of this study was to evaluate the safety and efficacy of bilateral ESPB with a liposomal bupivacaine/traditional bupivacaine mixture as part of an enhanced patient recovery pathway.

Improved Right Ventricular Diastolic Function Assessed by Hepatic Vein Flow After Pectus Excavatum Repair.

Background: The cardiovascular benefits of surgical repair in pectus excavatum (PEx) continue to be debated, with limited data supporting repair in adult patients. Hepatic vein flow is used to identify right-sided diastolic dysfunction in cardiovascular disorders, including tricuspid stenosis, cardiac tamponade, and constrictive pericarditis. This study evaluates the effects of cardiac compression on diastolic function (as assessed by hepatic vein flow patterns and velocities) before and after repair of PEx.

Pectus Excavatum in Cardiac Surgery Patients.

Background: Pectus excavatum frequently accompanies congenital heart disease and connective tissue diseases requiring cardiac surgery. Sometimes the indication is cardiac repair, with the pectus being incidentally noticed; other times, the pectus subsequently develops or becomes more significant after cardiac surgery. This review arms cardiac and congenital surgeons with background about the physiologic impact of pectus, indications for repair and repair strategies, and outcomes for cardiac surgery patients requiring pectus repair.

Prognostic factors in resected pulmonary carcinoid tumors: A retrospective study with 10 years of follow‑up.

The objective of the present study was to characterize the difference in 10-year carcinoid-specific survival (CSS) and disease-free survival (DFS) among patients with resected pulmonary typical carcinoid (TC) and atypical carcinoid (AC). Patients diagnosed with pulmonary carcinoid tumors (PCT) between January 1, 1997, and December 31, 2016, were identified. All patients underwent video-assisted thoracoscopic surgery or thoracotomy with thoracic lymphadenectomy.

Lobar versus sublobar resection for atypical lung carcinoid: An analysis from the National Cancer Database.

Background: There is a knowledge gap regarding lobar versus sublobar resection for atypical carcinoid (AC) of the lung. As such, the authors sought to understand and analyze the outcomes of sublobar resection versus lobectomy in this patient population.

Methods: A retrospective analysis using the National Cancer Database was performed to compare overall survival (OS) between patients treated with lobectomy and patients treated with sublobar resection for AC of the lung between the years 2004 and 2016.

Risk Factors and Techniques for Safe Pectus Bar Removal in Adults After Modified Nuss Repair.

Background: The Nuss repair involves implants designed for removal after 2 to 3 years. Although rare, significant complications can occur with bar removal, and the incidence of these complications may be higher in adults. This study was performed to review complications and risk factors associated with bar removal and discuss strategies to improve operative safety.

A Simple Method to Improve Intraoperative Localization of Fiducial Markers during Lung Resections.

 Lung cancer screening programs have increased the detection of early-stage lung cancer. High-resolution computed tomography can detect small, low-density pulmonary nodules, or ground-glass opacities. Obtaining a tissue diagnosis can be challenging, often necessitating surgical diagnosis.