Reduced Myocardial Strain Parameters in Subjects With Pectus Excavatum: Impaired Myocardial Function or Methodological Limitations Due to Chest Deformity?

2020 ◽  
Author(s):  
Andrea Sonaglioni ◽  
Gian Luigi Nicolosi ◽  
Alberto Granato ◽  
Michele Lombardo ◽  
Claudio Anzà ◽  
...  
Keyword(s):  
Pectus Excavatum ◽  
Myocardial Function ◽  
Myocardial Strain ◽  
Chest Deformity

scholarly journals Right Ventricular Compression Mimicking Brugada-Like Electrocardiogram in a Patient with Recurrent Pectus Excavatum

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Jinhee Ahn ◽  
Jong-Il Choi ◽  
Jaemin Shim ◽  
Sung Ho Lee ◽  
Young-Hoon Kim
Keyword(s):  
Pectus Excavatum ◽  
Surgical Correction ◽  
Mechanical Compression ◽  
St Segment Elevation ◽  
Skeletal Anomaly ◽  
St Segment ◽  
Chest Deformity ◽  
The Right ◽  
Electrocardiogram Ecg ◽  
Benign Course

Pectus excavatum (PE), the most common skeletal anomaly of chest wall, sometimes requires a surgical correction but recurrent PE is not uncommon. PE usually has a benign course; however, this chest deformity may be associated with symptomatic tachyarrhythmias due to mechanical compression. We report a case of a patient with recurrent PE after surgical correction presenting with palpitation and electrocardiogram (ECG) showing ST-segment elevation on the right precordial leads, which could be mistaken for a Brugada syndrome (BrS).

Differences in myocardial strain between pectus excavatum patients and healthy subjects assessed by cardiac MRI: a pilot study

2017 ◽  
Vol 28 (3) ◽  
pp. 1276-1284 ◽  
Author(s):  
André Lollert ◽  
Tilman Emrich ◽  
Jakob Eichstädt ◽  
Christoph Kampmann ◽  
Tariq Abu-Tair ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cardiac Mri ◽  
Healthy Subjects ◽  
Pectus Excavatum ◽  
Myocardial Strain

scholarly journals Research progress in the effects of pectus excavatum on cardiac functions

2020 ◽  
Vol 3 (2) ◽  
pp. e000142
Author(s):  
Caixia Liu ◽  
Yunhong Wen
Keyword(s):  
Cardiac Function ◽  
Chest Wall ◽  
Pectus Excavatum ◽  
Myocardial Strain ◽  
Clinical Work ◽  
Right Atrial ◽  
Research Progress ◽  
Cardiac Compression ◽  
Cardiac Functions ◽  
Negative Effect

BackgroundPectus excavatum, the most common chest wall deformity in children, accounts for nearly 90% of congenital malformations of chest wall. Initially, both parents and doctors paid more attention to the influence of this deformity on patient appearance and psychology. Following deeper studies of pectus excavatum, researchers found that it also affected cardiac functions. The purpose of this review aims to present recent research progress in the effects of pectus excavatum on cardiac functions.Data sourcesBased on aspects of CT, ultrasound cardiography (UCG) and MRI, all the recent literatures on the influence of pectus excavatum on cardiac function were searched and reviewed.ResultsModerate and severe pectus excavatum did have a negative effect on cardiac function. Cardiac rotation angle, cardiac compression index, right atrial and tricuspid annulus size, septal motion and myocardial strain are relatively effective indexes to evaluate cardiac function.ConclusionsPectus excavatum did have a negative effect on cardiac function; so surgeons should actively diagnose and treat such patients in clinical work. However, further research is needed on to explore the measures and indicators that can reflect the changes of cardiac function in patients objectively, accurately, effectively and timely.

Pectus Excavatum Breast and Chest Deformity: Indications for Aesthetic Plastic Surgery Versus Thoracic Surgery in a Multicenter Experience

2006 ◽  
Vol 30 (4) ◽  
pp. 403-411 ◽  
Author(s):  
Raymund E. Horch ◽  
Erich Stoelben ◽  
Roman Carbon ◽  
Alaa A. Sultan ◽  
Alexander D. Bach ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Plastic Surgery ◽  
Pectus Excavatum ◽  
Aesthetic Plastic Surgery ◽  
Chest Deformity

scholarly journals Combination of different thoracoplasty methods for recurrent pectus excavatum correction. Case report

2020 ◽  
Vol 27 (1) ◽  
pp. 53-56
Author(s):  
S. V. Kolesov ◽  
D. V. Khaspekov ◽  
A. A. Snetkov ◽  
A. S. Sar ◽  
G. S. Kolesov
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
High Risk ◽  
Chest Wall ◽  
Pectus Excavatum ◽  
Anterior Chest Wall ◽  
Open Resection ◽  
Implant Placement ◽  
Chest Deformity ◽  
Patients Wishes

A case of surgical treatment of recurrent funnel-shaped chest deformity with the formation of a complex pathological configuration of the anterior chest wall with the III degree of sinking of the sternal-costal complex in a 35-year-old woman is presented. After primary thoracoplasty, the patient underwent mammoplasty with implant placement, which made it difficult to correct the deformity, due to the high risk of damage to both the capsules formed around the implants and the implants themselves. In addition to the sinking of the sternum and adjacent ribs, the patient had a pronounced deformation of the costal arches according to the pterygoid type, which also required correction. In order to correct this deformity, we used a combination of two well known thoracoplasty methods-open resection and mini-invasive by D. NUSS. Thoracoplasty performed in this way allowed to significantly reduce the trauma of the operation, avoid complications, eliminate damage to the implants and, ultimately, get a pronounced cosmetic result that fully meets the patients wishes.

Deformities of the Thoracic Wall: Don't Forget the Plastic Surgeon

2018 ◽  
Vol 28 (04) ◽  
pp. 361-368 ◽  
Author(s):  
Anton Schwabegger
Keyword(s):  
Pectus Excavatum ◽  
Treatment Options ◽  
Costal Cartilage ◽  
Anterior Wall ◽  
Thoracic Wall ◽  
Reconstructive Procedures ◽  
Chest Deformity ◽  
Aesthetic Results ◽  
Pectus Bar ◽  
Single Method

AbstractSurgical procedures for pectus excavatum (PE) repair, such as minimally invasive repair of pectus excavatum or similar interventions (modified open videoendoscopically assisted repair of pectus excavatum), for remodeling the anterior thoracic wall may finally not always achieve sufficiently pleasing aesthetic results. Particularly in the asymmetric and polymorphic cases, remnant deformities may still be present after any sophisticated remodeling attempt. On the other hand, some cases despite optimal surgical management develop mild recurrences with partial concavity or rib cartilage distortion shortly after pectus-bar removal. Secondary treatment options then may include open access surgery, resection, or reshaping of deformed and prominent costal cartilage. Residual concave areas can be filled by autologous tissue, such as cartilage chips, liposhifting, or implantation of customized alloplastics. To provide the best options for a variety of primary or secondary postsurgical expressions of anterior wall deformities, any physician dealing with PE corrections should be familiar with various shaping and complementary reconstructive techniques or at least should have knowledge of such. However, among treating surgeons, there is an awareness that no single method can be applied for every kind of funnel chest deformity. Careful selection of appropriate techniques, either as a single approach for the ordinary deformities or in conjunction with ancillary procedures for the intricate cases, should be mandatory, based on the heterogeneity of symptoms, severity, expectations, and surgical and technical resources. A variety of such ancillary reconstructive procedures for PE repair are explained and illustrated herewith.

scholarly journals Minimal invasive surgical correction of pectus excavatum deformities in adolescents: Our institutional experience

2013 ◽  
Vol 141 (7-8) ◽  
pp. 503-506
Author(s):  
Radoica Jokic ◽  
Dragan Kravarusic ◽  
Milos Pajic ◽  
Jelena Antic ◽  
Zoran Vukasinovic
Keyword(s):  
Pectus Excavatum ◽  
Operative Time ◽  
Postoperative Recovery ◽  
Metal Plate ◽  
Minimal Invasive ◽  
Nuss Procedure ◽  
Chest Deformity ◽  
Institutional Experience ◽  
Pectus Bar ◽  
Invasive Surgical Approach

Introduction. Nuss procedure is a minimal invasive surgical technique based on retrosternal placement of a metal plate to correct pectus excavatum chest deformity. We are presenting our five?year (2006?2011) institutional experience of 21 patients. Objective. The aim of this study was to determine characteristics and advantages of minimal invasive surgical approach in correcting deformities of the chest. Methods. Surgical procedure, named after its author Nuss, involves the surgical placement of a molded metal plate, the so?called pectus bar, behind the sternum under thoracoscopic view whereby immediate controlled intraoperative corrections and stabilizations of the depression can be made. The great advantage of this method is reflected in a significant shortening of operative time, usually without indications for compensation in blood volume, and with a significantly shortened postoperative recovery that allows patients to quickly return to their normal activities. Results. In the period 2006?2011, 21 patients were operated by the Nuss procedure. The pectus bar was set in front or behind the muscles of the chest. Among the complications listed were inflammation of wounds in three patients, dislocation (shifting) of the bar requiring a reoperation in two patients, an occurrence of a pericardial effusion in one patient, and allergic response to foreign body in one patient. Five patients required extraction of the bar two years later, and three patients after three years, all with excellent results. Conclusion. Minimally invasive Nuss procedure is safe and effective. It currently represents the primary method of choice for solving the chest deformity pectus excavatum for patients of all ages. Modification of thoracoscopic control allows a safe field of operation. Postoperative results are excellent with very few complications that can be attributed to the learning curve.

scholarly journals P823 Usefulness of myocardial deformation imaging for assessment and long - term prognosis in young patients with Kawasaki disease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R Marinov ◽  
K Hristova ◽  
A Telcharova ◽  
I Chakarov
Keyword(s):  
Kawasaki Disease ◽  
Longitudinal Strain ◽  
Myocardial Function ◽  
Global Longitudinal Strain ◽  
Myocardial Strain ◽  
Myocardial Deformation ◽  
Healthy Children ◽  
2D Strain ◽  
Long Term Prognosis

Abstract Kawasaki disease is an autoimmune process, which characterizes with the engagement of arteries and especially - the coronary arteries of the heart.The aim of the study was to assess global and regional LV myocardial function and to predict the long-term prognosis of Kawasaki disease.Design and method: We analyzed 62 children (mean age 9,4 ±3,9 years ), 28 of them with a residual coronary aneurism and 20 healthy children ( mean age 9,6 ±4, 8). The myocardial deformation indexes of the LV – global and regional longitudinal, circumferential and radial stain were analyzed. The patients are divided into groups according to the type of treatment and the occurrence of complications - residual aneurysms. Apical, middle and basal short axis for 2D images were acquired (65 ± 7 frames/s) in addition to apical four, three and two-chamber views. Global and regional peak systolic strain - longitudinal, radial and circumferential of the LV was derived and the strain curves (eLL, eCC, eRR) were extracted using a commercial softwareResults: Global longitudinal strain measurements of the LV were non-significantly different between the Kawasaki group without an aneurysm and normals (GLS -19,81± 1,91% vs -19,69 ± 1,91%) In the group of Kawasaki with an aneurysm was found significantly reduced GLS compared to healthy patients (-17,25 ± 3.48% vs -19,69± 1,81%. ). Concerning the regional analysis,in the group with aneurysms, the radial, circumferential and longitudinal strain were significantly reduced, especially on the basal and middle LV-segments. Conclusion Decreased myocardial strain values are signs of regional hypokinesia with a possible local segmental ischemia in the group with coronary aneurysms on coronary artery and are marker for developing severe LV dysfunction in the future. The contribution in this study was the introduction of a new non-invasive assessment of myocardial function after Kawasaki disease, despite the apparently "normal" global systolic heart function. Global and regional myocardial strain 2D strain % Healthy controls Patients with Kawasaki disease and aneurysms Patients with Kawasaki disease without aneurysms 2Ds_rr 51.06 ± 4.95 37.24 ± 7.53* 41.91 ± 4.87 2Ds_cc -20.91 ± 0.76 -16.45 ± 3.01* -18.91 ± 2.73 2Ds_ll -19.69 ± 1.82 -17.25 ± 3.48* -19.81 ± 1.91 Basal level 2Ds_rr 2Ds_cc 2Ds_ll 52.03 ± 9.09 -20.68 ± 1.56 -19.74 ± 1.94 36.40 ± 12.57* -15.32 ± 2.81* -15.32 ± 2.81* 46.10± 8.37 -18.32 ± 2.01 -19.32 ± 0.97 Middle 2Ds_rr 2Ds_cc 2Ds_ll 49.54 ± 6.41 -21.3 ± 2.27 -20.92 ± 3.37 35.77 ± 9.26* -15.44 ± 3.04* -15.01 ± 2.79* 44.01 ± 10.12 -17.92 ± 1.11 -19.02 ± 1.31 Apical 2Ds_rr 2Ds_cc 2Ds_ll 51.30 ± 2.27 -21.30 ± 2.27 -20.92 ± 3.37 39.52 ± 12.93* -17.73 ± 4.45* -16.78 ± 4.49* 46.66± 8.57 -19.22 ± 1.87 -19.32 ± 1.01 * p < 0.01

Sign in / Sign up

Export Citation Format

Share Document