Original Article

Symmetrical excessive pectus excavatum in children

Asian Cardiovascular & Thoracic Annals 21(6) 683–688 ß The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492312467538 aan.sagepub.com

Akin Eraslan Balci1, Sevval Eren2 and Mehmet Oguzhan Ozyurtkan1

Abstract Objectives: The indications for repair of pectus excavatum are controversial. We present our surgical results in children with severe pectus excavatum. Methods: 27 children aged 6–15-years were included in the study. Pulmonary function tests and chest measurements were performed pre- and postoperatively. Deformed cartilages were resected subperichondrially, and a Kirchner wire was used to support the chest cage; it was removed 5 days after the operation. Fourteen children with restricted pulmonary function were considered to have excessive pectus excavatum. Results: 3 patients had asthma-like symptoms that resolved postoperatively. None suffered chest pain postoperatively. Postoperative hospital stay was 7.1 days. Only minor complications occurred postoperatively. The mean pectus severity index was 0.27  0.2 preoperatively and 0.41  0.1 postoperatively (p < 0.05). For children with restricted pulmonary function, it was 0.17  0.3 preoperatively and 0.38  0.2 postoperatively (p < 0.05). Mean percentage of predicted forced expiratory volume in 1 s changed significantly from 79.2%  17.8% preoperatively to 83.6%  12.2% by the 3rd postoperative month. For children with a pectus severity index 0.2 (18 cases, 6 with restricted pulmonary function), there was a difference in the mean PSI (0.31  0.05 vs. 0.43  0.02; p < 0.05) but not in the pre- and postoperative values of FEV1% (83  4.7 vs. 83.6  2.5, p ¼ 0.43). The mean preoperative FEV1% of children with PSI < 0.2 was less than that of the overall group (p < 0.05). FVC% values improved significantly postoperatively in both groups (Table 1). Pulmonary restriction correlated with a poor PSI (r ¼ 0.8; Figure 3). After 6 and 13 months, pulmonary function was similar, with a minor

Table 1. Results of pulmonary tests. Pectus severity index 0.2

Variable

Preoperative

Postoperative

p value

Preoperative

Postoperative

p value

FEV1% FVC%

68.5%  13.2% 64.5%  9.8%

82.3%  13.4% 68.7%  11.3%

0.0013 0.0026

83%  4.7% 81.6%  10.9%

83.6%  2.5% 83.4%  11.1%

0.4321 0.0097

FEV1%: predicted forced expiratory volume in 1 s; FVC: predicted forced vital capacity.

Downloaded from aan.sagepub.com at The University of Auckland Library on April 22, 2015

686

Asian Cardiovascular & Thoracic Annals 21(6)

Figure 3. Correlation between pectus severity index and percentage of predicted forced expiratory volume in 1 s (FEV1%).

Table 2. Results of cardiac tests. Pectus severity index 0.2

Variable

Preoperative

Postoperative

p value

Preoperative

Postoperative

p value

LVEDVI LVESVI LVSVI RVESVI RVEDVI RVSVI

52.4  6.1 16.9  5.2 30.7  7.4 6.5  1.3 17.1  3 9.5  1.7

55.9  10.2 17  5.3 38.6  7.4 12.4  2.7 30.8  6.6 20.1  3.1

0.0318 0.1753

Symmetrical excessive pectus excavatum in children.

The indications for repair of pectus excavatum are controversial. We present our surgical results in children with severe pectus excavatum...
178KB Sizes 0 Downloads 3 Views