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Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery
: OBJECTIVES: Pectus excavatum (PE) can be secondary in patients who underwent sternotomy for cardiac surgery. Retrosternal adhesions increase the complexity and risk of traditional Nuss repair. Thus, we summarized the outcomes of our modified Nuss procedure using a newly designed bar. METHODS: A r...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860435/ https://www.ncbi.nlm.nih.gov/pubmed/34661678 http://dx.doi.org/10.1093/icvts/ivab284 |
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author | Liu, Siming Wang, Lei Zhang, Hongkun Zeng, Wenhui Hu, Fengqing Xiao, Haibo Li, Guoqing Mei, Ju Zhu, Jiaquan |
author_facet | Liu, Siming Wang, Lei Zhang, Hongkun Zeng, Wenhui Hu, Fengqing Xiao, Haibo Li, Guoqing Mei, Ju Zhu, Jiaquan |
author_sort | Liu, Siming |
collection | PubMed |
description | : OBJECTIVES: Pectus excavatum (PE) can be secondary in patients who underwent sternotomy for cardiac surgery. Retrosternal adhesions increase the complexity and risk of traditional Nuss repair. Thus, we summarized the outcomes of our modified Nuss procedure using a newly designed bar. METHODS: A retrospective analysis was performed on 35 patients who underwent modified PE repair after open heart surgery from January 2011 to July 2019. The surgery was performed using a novel bar with no need for intraoperative reshaping and rotation, assisted by thoracoscopy and subxiphoid incision when necessary. RESULTS: There were 19 males and 16 females with a median age of 5.3 years (interquartile range, 4.1–10.9) at PE repair. All patients underwent the modified procedure uneventfully with no death. The median operating time was 70 min. Twenty-nine (82.9%) patients required subxiphoid incision assistance. There was 1 case (2.8%) with unexpected sternotomy due to intraoperative bleeding. The median length of postoperative hospital stay was 4 days. During the median 3.5 years of follow-up, no bar dislocation was found and 30 (85.7%) patients had their bars removed with no recurrence recorded. After PE repair, the Haller index improved significantly (2.6 ± 0.4 vs 4.9 ± 1.3, P < 0.05) and further decreased till the time of bar removal (2.5 ± 0.4 vs 2.6 ± 0.4, P < 0.05). All patients were satisfied with the cosmetic outcome. CONCLUSIONS: The novel bar can be placed and removed easily with a low rate of adverse events. This modified Nuss procedure seems to be a safe, effective and convenient approach for the management of PE after cardiac surgery. |
format | Online Article Text |
id | pubmed-8860435 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-88604352022-02-22 Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery Liu, Siming Wang, Lei Zhang, Hongkun Zeng, Wenhui Hu, Fengqing Xiao, Haibo Li, Guoqing Mei, Ju Zhu, Jiaquan Interact Cardiovasc Thorac Surg Thoracic : OBJECTIVES: Pectus excavatum (PE) can be secondary in patients who underwent sternotomy for cardiac surgery. Retrosternal adhesions increase the complexity and risk of traditional Nuss repair. Thus, we summarized the outcomes of our modified Nuss procedure using a newly designed bar. METHODS: A retrospective analysis was performed on 35 patients who underwent modified PE repair after open heart surgery from January 2011 to July 2019. The surgery was performed using a novel bar with no need for intraoperative reshaping and rotation, assisted by thoracoscopy and subxiphoid incision when necessary. RESULTS: There were 19 males and 16 females with a median age of 5.3 years (interquartile range, 4.1–10.9) at PE repair. All patients underwent the modified procedure uneventfully with no death. The median operating time was 70 min. Twenty-nine (82.9%) patients required subxiphoid incision assistance. There was 1 case (2.8%) with unexpected sternotomy due to intraoperative bleeding. The median length of postoperative hospital stay was 4 days. During the median 3.5 years of follow-up, no bar dislocation was found and 30 (85.7%) patients had their bars removed with no recurrence recorded. After PE repair, the Haller index improved significantly (2.6 ± 0.4 vs 4.9 ± 1.3, P < 0.05) and further decreased till the time of bar removal (2.5 ± 0.4 vs 2.6 ± 0.4, P < 0.05). All patients were satisfied with the cosmetic outcome. CONCLUSIONS: The novel bar can be placed and removed easily with a low rate of adverse events. This modified Nuss procedure seems to be a safe, effective and convenient approach for the management of PE after cardiac surgery. Oxford University Press 2021-10-18 /pmc/articles/PMC8860435/ /pubmed/34661678 http://dx.doi.org/10.1093/icvts/ivab284 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Thoracic Liu, Siming Wang, Lei Zhang, Hongkun Zeng, Wenhui Hu, Fengqing Xiao, Haibo Li, Guoqing Mei, Ju Zhu, Jiaquan Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery |
title | Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery |
title_full | Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery |
title_fullStr | Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery |
title_full_unstemmed | Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery |
title_short | Modified Nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery |
title_sort | modified nuss procedure with a novel steel bar in patients with pectus excavatum post-congenital heart surgery |
topic | Thoracic |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860435/ https://www.ncbi.nlm.nih.gov/pubmed/34661678 http://dx.doi.org/10.1093/icvts/ivab284 |
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