The relation of pectus excavatum to heart disease

Wachtel, Fred W.; Ravitch, Mark M.; Grishman, Arthur

doi:10.1016/0002-8703(56)90122-3

Cited by 64 publications

(23 citation statements)

References 27 publications

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“…Severe chest deformities like kyphoscoliosis may produce gross disturbances of cardiac function (Wachtel, Ravitch, and Grishman, 1956;Hanley et al, 1958), but in cases of straight back syndrome these have not been encountered by us nor have they been reported.…”

Section: Discussionmentioning

confidence: 84%

Straight Back Syndrome

Datey¹,

Deshmukh²,

Dalvi³

1964

Heart

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Section: Discussionmentioning

confidence: 84%

Straight Back Syndrome

Datey¹,

Deshmukh²,

Dalvi³

1964

Heart

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“…The radiographic findings of pectus excavatum have been well described, and they include displacement of the heart into the left hemithorax with mild clockwise rotation and a pancake-like appearance of the heart with an increase of the frontal silhouette to the left 2. The possible mechanisms that produce circulatory problems in individuals with pectus excavatum include: 1) decreased inflow due to cardiac rotation and twisting of the great veins; 2) cardiac compression, especially of the atria, resulting in supraventricular; 3) impaired diastolic expansion; and 4) decreased respiratory effort 2…”

Section: Discussionmentioning

confidence: 99%

“…The depression in the pectus excavatum is usually deepest a little above the xiphisternal junction 2. The xiphisternal junction can hardly be detected in some children by the transverse image alone, because the image shows cartilage, but not sufficient ossification.…”

Section: Methodsmentioning

confidence: 99%

Development of New Cardiac Deformity Indexes for Pectus Excavatum on Computed Tomography: Feasibility for Pre- and Post-Operative Evaluation

et al. 2009

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PurposeThe aim of this study was to evaluate new cardiac deformity indexes (CDIs) for diagnosis of pectus excavatum as well as morphological assessment of heart on computed tomography (CT).Materials and MethodsWe retrospectively evaluated the CT images of the control group (n=200), and the pectus excavatum before and after correction groups (n=178), and calculated the CDIs; cardiac compression index (CCI), and cardiac asymmetry index (CAI). We also calculated chest wall compression index (CWCI) and asymmetry index (CWAI) on the axial images. We performed logistic regression analysis using each index and age as predictor variables.ResultsThe CDIs (CCI and CAI) were significant (p < 0.05) in the diagnosis of pectus excavatum, regardless of age (p = 0.4033, p = 0.8113). The CWCI and CWAI were significant (p < 0.05) and significantly affected by age (p < 0.05). If we selected 1.82 as the cutoff of the CCI, the sensitivity and specificity were 99.4% and 98%, respectively. The following cutoffs and the sensitivity and specificity were obtained: 1.15 for the CAI gave 94.4% and 94.5%, 3.05 for the CWCI gave 92.1% and 92%, and 1 for the CWAI gave 62.4% and 65%, respectively. The CCI after repair improved from 2.83 ± 0.84 to 1.84 ± 0.33, while the CWCI improved from 4.49 ± 1.61 to 2.57 ± 0.44.ConclusionCDIs such as the CCI and CAI may be potentially useful to detect and estimate repair for pectus excavatum.

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“…Associated congenital cardiac abnormalities have been described (Edeiken and Wolferth, 1932;Evans, 1946;Sutton, 1947;Wachtel, Ravitch, and Grishman, 1956). Right ventricular pressures have been recorded (Lyons, Zuhdi, and Kelly, 1955).…”

mentioning

confidence: 99%

Pectus excavatum

Wooler

Mashhour

García

et al. 1969

Thorax

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The deformity of pectus excavatum is caused by a negative pressure in the anterior mediastinum sucking in the body of the sternum. This is usually due to the heart lying on the left side, leaving the mediastinum empty so that the sternum and costal cartilages are sucked in to fill the empty space. The operation consists of excising the deformed cartilages, mobilizing the sternum, and suturing the pericardial sac into a central position which corrects the deformity.Pectus excavatum, funnel chest, depressed sternum, and chonechondrosternon (Ochsner and DeBakey, 1939;Ochsner and Ochsner, 1966) are pseudonyms describing the same deformity of which the aetiology remains unknown and open to speculation. Brodkin (1953) and Chin (1957) blame the xiphoid origin of the diaphragm pulling the lower part of the sternum backwards. Mullard (1967) considers it is due to failure of osteogenesis and chondrogenesis of the anterior chest wall. Brown (1939) described the pathological changes of the chest wall in advanced pectus excavatum but offered no explanation for its causation.The diverse ways of correcting the deformity prove that no method is entirely satisfactory. Many authors recommend a rigid internal or external splint (

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The relation of pectus excavatum to heart disease

Cited by 64 publications

References 27 publications

Straight Back Syndrome

Straight Back Syndrome

Development of New Cardiac Deformity Indexes for Pectus Excavatum on Computed Tomography: Feasibility for Pre- and Post-Operative Evaluation

Pectus excavatum

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