RT Book, Section
A1 Frantz, Frazier W.
A1 Goretsky, Michael J.
A1 Shamberger, Robert C.
A2 Ziegler, Moritz M.
A2 Azizkhan, Richard G.
A2 Allmen, Daniel von
A2 Weber, Thomas R.
SR Print(0)
ID 1100432512
T1 Pectus Excavatum
T2 Operative Pediatric Surgery, 2e
YR 2014
FD 2014
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-162723-8
LK accesssurgery.mhmedical.com/content.aspx?aid=1100432512
RD 2024/04/25
AB Surgical  repair  of  pectus  excavatum  is  indicated  for  patients  with  a  severe  pectus  deformity  and  associated  physiologic  impairment.Cardiorespiratory  impairment  associated  with  severe  pectus  excavatum  has  been  characterized  and  measured  by  pulmonary  function  testing,  morphologic  and  functional  echocardiographic  assessment,  cardiovascular  magnetic  resonance  imaging  (CMR),  and  incremental  exercise  testing.Relief  of  cardiac  compression  after  pectus  repair  is  associated  with  increased  stroke  volumes  and  subsequent  improvements  in  exercise  capacity  and  cardiovascular  performance.The  optimal  timing  for  pectus  excavatum  repair  appears  to  be  10  to  14  years  of  age,  when  the  chest  wall  is  still  malleable.  Repairs  done  in  this  age  range  are  associated  with  a  low  incidence  of  recurrent  pectus  excavatum.The  Nuss  procedure  is  now  used  for  the  majority  of  primary  pectus  excavatum  repairs.Open  repair  is  used  primarily  for  patients  with  severe  asymmetry  of  the  chest  wall,  mixed  pectus  deformities,  or  if  there  are  objections  to  having  a  substernal  bar  in  place  for  2  to  3  years.Both  the  Nuss  procedure  and  open  repair  methods  provide  excellent  results  with  low  complication  and  recurrence  rates.