HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shamberger, R. C. Articles by Fyler, D. C. Search for Related Content PubMed PubMed Citation Articles by Shamberger, R. C. Articles by Fyler, D. C.

The Journal of Thoracic and Cardiovascular Surgery, Vol 96, 427-432, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Anterior chest wall deformities and congenital heart disease

RC Shamberger, KJ Welch, AR Castaneda, JF Keane and DC Fyler
Department of Surgery, Children's Hospital, Boston, Mass. 02115.

Pectus excavatum and pectus carinatum usually exist as isolated abnormalities. Only 19 cases of associated congenital heart defects have been reported. Significant complications related to uncorrected pectus excavatum have been described either during or after cardiac operations. Therefore we reviewed our experience with these coexisting lesions to assess the risk of surgical repair of chest wall deformities before and after correction of congenital cardiac anomalies. Among 20,860 infants and children with congenital heart disease seen at our institution, 36 (0.17%) had associated anterior thoracic deformities, 22 of whom underwent surgical correction of pectus excavatum or pectus carinatum. Ten of these 22 patients had pectus repair after a cardiac operation. Pleural or pericardial entry was avoided in all and none required a blood transfusion. Ten other patients had pectus repair either before cardiac repair (five patients) or without a subsequent cardiac operation. Another patient had a cardiac operation performed through a median sternotomy both before and after pectus repair, and the remaining patient, early in the series, had simultaneous banding of the main pulmonary artery and repair of pectus excavatum complicated by chest wall instability and a lethal intrathoracic hemorrhage. The experience indicates that congenital chest wall deformities can be safely and effectively repaired after early correction of congenital heart defects through a median sternotomy, although repair of the chest wall deformity after cardiac surgery also gives good results. However, in children who require an extracardiac conduit for repair of their congenital heart defect, we recommend initial repair of the pectus excavatum followed at 6 weeks or later by repair of the cardiac lesion to eliminate possible extrinsic compression of the conduit by the depressed sternum. We avoid simultaneous cardiac and pectus excavatum repair because of potential associated major complications.

This article has been cited by other articles:

				S. Takabayashi, K. Yokoyama, H. Ohashi, Y. Mitani, and H. Shimpo Suture Repair of Pectus Excavatum at the Time of Cardiac Surgery on an Infant Ann. Thorac. Surg., February 1, 2008; 85(2): 651 - 653. [Abstract] [Full Text] [PDF]

				K. C. Javangula, T. J.P. Batchelor, O. Jaber, K. G. Watterson, and K. Papagiannopoulos Combined Severe Pectus Excavatum Correction and Aortic Root Replacement in Marfan's Syndrome. Ann. Thorac. Surg., May 1, 2006; 81(5): 1913 - 1915. [Abstract] [Full Text] [PDF]

				S.-i. Oki, Y. Misawa, and K. Fuse A repair of funnel chest without sternal dissection in aortic root replacement Eur. J. Cardiothorac. Surg., January 1, 2003; 23(1): 109 - 111. [Abstract] [Full Text] [PDF]

				T. Hasegawa, M. Yamaguchi, Y. Ohshima, N. Yoshimura, S. Oka, and Y. Ootaki Simultaneous repair of pectus excavatum and congenital heart disease over the past 30 years Eur. J. Cardiothorac. Surg., December 1, 2002; 22(6): 874 - 878. [Abstract] [Full Text] [PDF]

				C. L. Willekes, C. L. Backer, and C. Mavroudis A 26-year review of pectus deformity repairs, including simultaneous intracardiac repair Ann. Thorac. Surg., February 1, 1999; 67(2): 511 - 518. [Abstract] [Full Text] [PDF]