Purpose. Pectus deformities and cardiac problems sometimes require simultaneous surgery. We report our experience of performing this surgery and review the relevant literature. Methods. We performed simultaneous pectus deformity correction and open-heart surgery in six patients between 1999 and 2006. The pectus deformities were pectus carinatum in one patient and pectus excavatum in fi ve patients. The cardiac problems were coronary artery disease in one patient, an atrioseptal defect (ASD) with a ventricular septal defect (VSD) in one, a VSD in one, mitral valve insuffi ciency with left atrial dilatation in one, and an ascending aortic aneurysm with aortic valve insuffi ciency caused by Marfan's syndrome in two. We corrected the pectus deformities using the modifi ed Ravitch's sternoplasty in all patients. First, while the patient was supine, we resected the costal cartilage; then, after completing the cardiac surgery, the sternum was closed and the additional time required for the pectus operation was calculated for each patient. Patients were examined 1, 4, and 6 months postoperatively. Results. The average operation time was 102 min, and there were no major complications. The pectus bars were removed 4-6 months postoperatively. Good cardiac and cosmetic results were achieved in all patients, who were followed up for 5 years. Conclusions. Concomitant pectus deformity correctionand open-heart surgery can be performed safely, eliminating the risks of a second operation in a staged procedure.

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Castleman's disease is a rare lymphoproliferative disease and its etiology is still unknown. It may occur at every site where lymph tissue is present. A definitive treatment is possible with complete resection. The most important problem is bleeding which may occur during surgery due to the high vascularization. In this study, we present the surgical treatment of a case with mediastinal Castleman's disease, treated preoperatively with embolization because of hypervascularization detected on thoracic CT.

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