Emergent cardiopulmonary bypass during pectus excavatum repair

Craner, Ryan C.; Weis, Ricardo A.; Ramakrishna, Harish

doi:10.4103/0971-9784.114249

Cited by 6 publications

(3 citation statements)

References 27 publications

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“… 2 , 3 Repair of pectus excavatum after a previous cardiac surgery can be extremely challenging especially due to the postsurgical adhesions between the sternum and heart. 5 Ravitch type procedures have occasionally been used and authors state that this technique is a safe and reliable approach in cases of simultaneous repair. 1 , 2 …”

Section: Discussionmentioning

confidence: 99%

“…In the past more invasive procedures have also been described, such as the sternal turnover, eversion in a trapdoor fashion, turnover with internal thoracic-vessel presentation or even a modified Nuss procedure. 1 , 3 , 5 These techniques offer excellent operative exposure but they are associated with a high percentage of wound infection or sternal necrosis, despite the preservation of the internal thoracic blood supply. 1 …”

Section: Discussionmentioning

confidence: 99%

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Aortic root replacement and valvuloplasty in a woman with severe pectus excavatum

Kalogris

Iliadis

Amanatidis

et al. 2018

J Cardiovasc Thorac Res

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We describe a case of a 43-year old woman with Marfan’s syndrome, tricuspid valve regurgitation and severe pectus excavatum who required an aortic root replacement and valvuloplasty for an ascending aortic aneurism with aortic valve regurgitation and tricuspid valve regurgitation. There was a severe angulation of the sternum which was close to 1.5 cm to the column vertebrae. Such cases are quite rare and always a challenge for surgeons to achieve adequate exposure of the heart and prevent excessive cardiac compression. We present our access, a safe and efficient exposure of the heart in order to achieve the best outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Aortic root replacement and valvuloplasty in a woman with severe pectus excavatum

Kalogris

Iliadis

Amanatidis

et al. 2018

J Cardiovasc Thorac Res

View full text Add to dashboard Cite

show abstract

“…[52] The ability to perform effective chest compressions in the event of cardiac arrest is also significantly hampered due to the presence of the chest wall bars. [53] A transesophageal echocardiogram (TEE)[5455] may prove valuable by real time intraoperative monitoring for cardiac compression and injury.…”

Section: Anesthetic Managementmentioning

confidence: 99%

Anesthesia for minimally invasive chest wall reconstructive surgeries: Our experience and review of literature

et al. 2017

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Minimal access procedures have revolutionized the field of surgery and opened newer challenges for the anesthesiologists. Pectus carinatum or pigeon chest is an uncommon chest wall deformity characterized by a protruding breast bone (sternum) and ribs caused by an overgrowth of the costal cartilages. It can cause a multitude of problems, including severe pain from an intercostal neuropathy, respiratory dysfunction, and psychologic issues from the cosmetic disfigurement. Pulmonary function indices, namely, forced expiratory volume over 1 s, forced vital capacity, vital capacity, and total lung capacity are markedly compromised in pectus excavatum. Earlier, open surgical correction in the form of the Ravitch procedure was followed. Currently, in the era of minimally invasive surgery, Nuss technique (pectus bar procedure) is a promising step in chest wall reconstructive surgery for pectus excavatum. Reverse Nuss is a corrective, minimally invasive surgery for pectus carinatum chest deformity. A tailor-made anesthetic technique for this new procedure has been described here based on the authors’ personal experience and thorough review of literature based on Medline, Embase, and Scopus databases search.

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Post‐operative arrest following pectus excavatum repair: A case report with a systematic review of the published case reports

Roostaei,

Amini,

Abtahi

et al. 2024

Clinical Case Reports

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Key Clinical MessageCommon complications after PE surgery include ventricular tachycardia, cardiac arrest, pneumothorax, and bar displacement. These can lead to severe outcomes, emphasizing the need for caution and meticulous post‐operative monitoring. Patients and their families should be well‐informed about potential risks during the consent process.AbstractThe objective of this study was to raise awareness among medical staff and surgeons about potential complications, particularly rare and life‐threatening ones, associated with pectus excavatum (PE) surgery. PE is the most common chest wall deformity, characterized by sternal depression. Patients primarily seek treatment for cosmetic concerns, but some also report exercise intolerance and shortness of breath. Although surgical repair is the standard treatment, the incidence and nature of severe complications remain unclear and underreported. This study presents a case of a lethal cardiac event following PE surgery and conducts a systematic review of published case reports. This study describes a case of a lethal complication of ventricular fibrillation and cardiac arrest following the Ravitch procedure for correction of PE in a 10‐year‐old boy. A systematic review of relevant cases of PE surgery complications was conducted. Of the 506 initial records retrieved, 93 case reports from 83 articles were identified over the 23 years. Among them, 72 patients were male, and 20 cases were female. The average age of patients was 19.2 ± 7.7 years (range: 5–53). Complications had occurred up to 37 years from the time of surgery, with most of the cases (22.5%) occurring during the operation. The most frequent complications included cardiothoracic issues and displacement of the implanted steel bar. In nine patients, complications led to fatal outcomes. Due to the possible risks of PE surgery, particularly in cosmetically motivated cases, surgeons must exercise extreme caution and remain vigilant for rare and potentially life‐threatening complications.

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Emergent cardiopulmonary bypass during pectus excavatum repair

Cited by 6 publications

References 27 publications

Aortic root replacement and valvuloplasty in a woman with severe pectus excavatum

Aortic root replacement and valvuloplasty in a woman with severe pectus excavatum

Anesthesia for minimally invasive chest wall reconstructive surgeries: Our experience and review of literature

Post‐operative arrest following pectus excavatum repair: A case report with a systematic review of the published case reports

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