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.

Abstract 16138: Chest and Cardiac Compression on CT/MRI and on TEE Predicts Improvement in Right Heart Chamber Size and Right Ventricular Deformation Post Pectus Excavatum Repair Surgery

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Chieh-Ju Chao ◽  
Michael B Gotway ◽  
Dawn E Jaroszewski ◽  
Steven Lester ◽  
Samuel Unzek ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Pectus Excavatum ◽  
Global Longitudinal Strain ◽  
Right Atrial ◽  
Right Heart ◽  
Cardiac Chamber ◽  
Heart Chamber ◽  
Cardiac Compression ◽  
2D Strain ◽  
Chamber Size

Background: Pectus excavatum (PE) deformity involves posterior depression of the sternum and adjacent costal cartilages. The relationship of CT/MRI chest cardiac compression indices used as indications for surgical repair of PE with echocardiographic findings and with improvement in cardiac chamber compression and function post PE repair is unknown. Methods: We evaluated right atrial (RA) size, tricuspid annulus (TA size, right ventricular (RV) outflow tract size as well as RV 2D strain on intra-operative trans-esophageal echocardiography (TEE) immediately pre and post surgical PE repair. Inspiratory and expiratory Haller Index (HI) and cardiac compression indices (CCI) were measured on pre op CT/MR scans (Figure). Offline measurement of chamber dimensions on TEE images was performed and Speckle tracking strain measurements were made using Syngo US Workplace software (Siemens). P<0.05 was considered significant. Results: 60 patients, 73% male, 27% female, age 33.6±10.3 yrs underwent PE repair following CT/MRI from 2010-2014 (Figure). There was a strong correlation between expiratory CT/MRI chest AP diameter and pre-op RA size (panel A). Pre op RA and TA compression on TEE inversely correlated with pre op RV global longitudinal strain rate(RVGLSR) (panels B & C). CCI predicted improvement in RA size post PE repair (panels D & E). In addition pre op RA size on TEE correlated with improvement in RVGLSR post PE repair surgery (panel F). Conclusion: In patients with PE deformity, pre surgical CCI correlated with right-sided cardiac chamber compression on pre op TEE. Severity of chest and cardiac compression also predicted magnitude of improvement in right-sided chamber size and RV longitudinal deformation post PE repair. Our findings provide insight regarding the beneficial effects of PE surgery on right heart chamber compression and improvement in RV function and the important role of intraoperative TEE for patients undergoing PE repair surgery.

Does chest wall conformation influence myocardial strain parameters in infants with pectus excavatum?

2021 ◽  
Author(s):  
Andrea Sonaglioni ◽  
Gian Luigi Nicolosi ◽  
Marta Braga ◽  
Maria Cristina Villa ◽  
Claudio Migliori ◽  
...  
Keyword(s):  
Chest Wall ◽  
Pectus Excavatum ◽  
Myocardial Strain

Minimally Invasive Repair of Pectus Excavatum (MIRPE) - The Basel Experience

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 289-295 ◽  
Author(s):  
Haecker ◽  
Bielek ◽  
von Schweinitz
Keyword(s):  
Minimally Invasive ◽  
Pectus Excavatum ◽  
Pulmonary Function Tests ◽  
Preoperative Evaluation ◽  
Skin Incision ◽  
Original Method ◽  
Restrictive Lung Disease ◽  
Cardiac Compression ◽  
Cardiac Evaluation ◽  
Indications For Operation

Purpose: Minimally invasive repair of pectus excavatum (MIRPE) was first reported in 1998 by D. Nuss. This technique has gained wide acceptance during the last 4-5 years. In the meantime, some modifications of the technique have been introduced by different authors. Our retrospective study reports our own experience over the last 36 months and modifications introduced due to a number of complications. Methods: From 3/2000 to 3/2003, 22 patients underwent MIRPE. Patients median age was 15.5 years (10.7 to 20.3 years). Standardised preoperative evaluation included 3D computerised tomography (CT) scan, pulmonary function tests, cardiac evaluation with electrocardiogram and echocardiography, and photo documentation. Indications for operation included at least two of the following: Haller CT index > 3.2, restrictive lung disease, cardiac compression, progression of the deformity and severe psychological alterations. Results: In 22 patients (2 girls, 20 boys) undergoing MIRPE procedure, a single bar was used in 21 patients and two bars in one boy. Lateral stabilisers were fixed with non resorbable sutures on both sides. Overall, postoperative complications occurred in six patients (27.3%). In two patients (9.1%) a redo-procedure was necessary due to bar displacement. An additional median skin incision was performed in two patients to elevate the sternum. Pneumothorax or hematothorax in two patients resulted in routine use of a chest tube on both sides. Long-term favourable results were noted in all patients. Conclusions: The MIRPE procedure is an effective method with elegant cosmetic results. Modifications of the original method help to decrease the complication rate and to accelerate acquirement of expertise.

Canine thoracic electrical impedance with changes in pulmonary gas and blood volumes

1982 ◽  
Vol 53 (6) ◽  
pp. 1608-1613
Author(s):  
R. M. Smith ◽  
B. A. Gray
Keyword(s):  
Chest Wall ◽  
Blood Volume ◽  
Vena Cava ◽  
Systemic Circulation ◽  
Aortic Pressure ◽  
Right Atrial ◽  
Liquid Content ◽  
Primary Determinant ◽  
Residual Capacity ◽  
Lung Liquid

The purpose of this study was to evaluate transthoracic impedance (Z) as an index of total lung liquid content at constant lung gas volume (LGV). To this end we produced rapid changes in pulmonary blood volume (PBV) in anesthetized, paralyzed, closed-chest dogs with the airway occluded at functional residual capacity. Changes in PBV produced by inflation of balloons on catheters positioned in the left atrium (LA) or inferior vena cava (IVC) were estimated from the changes in chest wall recoil pressure, using the chest wall as a plethysmograph after calibration with changes in LGV. Whereas Z increased linearly with decreases in PBV (1–6 ml/kg) produced by the IVC balloon (% delta Z/delta PBV = -0.43 ml/kg, r = -0.81), Z did not change significantly with increases in PBV (1–6 ml/kg) produced by the LA balloon. These observations indicate that changes in PBV are not the primary determinant of changes in Z and raise the possibility that other hemodynamic events are more important. Whereas aortic pressure decreased with both IVC and LA balloon inflations, right atrial pressure (Pra) increased with mitral valve obstruction and decreased with IVC obstruction. Changes in chest wall blood volume in response to changes in Pra could explain the changes in thoracic impedance. Thus, even at constant LGV, events in the systemic circulation appear to invalidate Z as an indicator of lung liquid content.

scholarly journals How to assess chest wall deformity in children with pectus excavatum - evaluation of the agreement among methods

2019 ◽  
pp. 71-71
Author(s):  
Marko Kostic ◽  
Aleksandar Sretenovic ◽  
Milan Savic ◽  
Marko Popovic ◽  
Sanja Kostic ◽  
...  
Keyword(s):  
Chest Wall ◽  
Pectus Excavatum ◽  
Chest Wall Deformity

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

Current Options for the Treatment of Pectus Carinatum: When to Brace and When to Operate?

2018 ◽  
Vol 28 (04) ◽  
pp. 347-354 ◽  
Author(s):  
Sherif Emil
Keyword(s):  
Minimally Invasive ◽  
Chest Wall ◽  
Pectus Excavatum ◽  
Surgical Correction ◽  
Diagnosis And Treatment ◽  
Pectus Carinatum ◽  
The Past ◽  
Minimally Invasive Surgical

AbstractPectus carinatum has traditionally been described as a rare chest wall anomaly in comparison to pectus excavatum. However, recent data from chest wall anomaly clinics demonstrate that this deformity is probably much more frequent than once believed. In the past, invasive surgical correction by the Ravitch technique was essentially the only option for treatment of pectus carinatum. Major advances over the past two decades have provided additional options, including noninvasive chest wall bracing and minimally invasive surgical correction. This article will discuss current options for the treatment of pectus carinatum, and some of the factors that should be taken into account when choosing the options available. Diagnosis and treatment of the pectus arcuatum variant will also be described.

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