AI Article Synopsis
- This study addresses the lack of guidelines for patients with pectus deformities undergoing cardiac surgery and shares the results of a specific surgical approach.
- Eleven patients from three centers underwent a modified Ravitch procedure, which included a unique method for rib cartilage resection to aid in cardiac surgery, ensuring chest wall stability post-operation.
- Results showed no operative mortality, high patient satisfaction with a mean cosmetic score of 97.3, and the procedure improved access for cardiac surgery without increasing risks, indicating its effectiveness in adults with pectus deformities.
Article Abstract
Objectives: There is currently a lack of recommendations about patients with pectus deformities requiring cardiac surgery. This study reports the results of our surgical strategy on this issue.
Methods: Eleven patients, from three centers treated over a 9-year period were included in this study. Pectus deformities were operated with a modified Ravitch procedure. In the case of pectus excavatum repair and concomitant cardiac surgery, subperichondrial resection of abnormal rib cartilages was always performed before the sternotomy and an easily removable retrosternal metallic strut was inserted at the end of the procedure ensuring anterior chest wall stability. During follow-up patients had to estimate their current appearance with a numeric scale ranging from 0 to 100.
Results: Mean age was 27 ± 9.4 years. Pectus excavatum was present in 8 patients and pectus arcuatum in 3. There were 6 Marfan syndrome patients. Nine patients had concomitant surgery and, 2 underwent pectus repair after a history of cardiac surgery. There was no operative mortality. In the case of concomitant surgery, heart exposure through median sternotomy was facilitated by abnormal rib cartilage resection. Median follow-up was 54 months (range 16.7-119.7). Mean cosmetic result evaluated by the patients was 97.3 (±2.5).
Conclusions: In adults, concomitant scheduled surgery is reliable and offers excellent long-term cosmetic results. Moreover, it allows a better thoracic exposition with no added perioperative risk. The modified Ravitch technique seems more adequate in these patients as it can be used in all types of pectus deformities.
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| http://dx.doi.org/10.1016/j.ijcard.2015.05.100 | DOI Listing |
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