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Pectus Excavatum in Cardiac Surgery Patients.
Stephens, Elizabeth H; Dearani, Joseph A; Jaroszewski, Dawn E.
Afiliação
  • Stephens EH; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
  • Dearani JA; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
  • Jaroszewski DE; Division of Thoracic Surgery, Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Phoenix, Arizona. Electronic address: stephens.elizabeth@mayo.edu.
Ann Thorac Surg ; 115(5): 1312-1321, 2023 05.
Article em En | MEDLINE | ID: mdl-36781097
BACKGROUND: Pectus excavatum frequently accompanies congenital heart disease and connective tissue diseases requiring cardiac surgery. Sometimes the indication is cardiac repair, with the pectus being incidentally noticed; other times, the pectus subsequently develops or becomes more significant after cardiac surgery. This review arms cardiac and congenital surgeons with background about the physiologic impact of pectus, indications for repair and repair strategies, and outcomes for cardiac surgery patients requiring pectus repair. METHODS: A comprehensive literature review was performed using keywords related to pectus excavatum, pectus repair, and cardiac/congenital heart surgery within the PubMed database. RESULTS: The risks of complications related to pectus repair, including in the setting of cardiac surgery or after cardiac surgery, are low in experienced hands, and patients demonstrate cardiopulmonary benefits and symptom relief. Concomitant pectus and cardiac surgery should be considered if it is performed in conjunction with those experienced in pectus repair, particularly given the increased cardiopulmonary impact of pectus after bypass. In the setting of potential bleeding or hemodynamic instability, delayed sternal closure is recommended. For those with anticipated pectus repair after cardiac surgery, the pericardium should be reconstructed for cardiac protection. For those undergoing pectus repair after cardiac surgery without a membrane placed, a "hybrid" approach is safe and effective. CONCLUSIONS: Patients undergoing cardiac surgery noted to have pectus should be considered for possible concomitant or staged pectus repair. For those who will undergo a staged procedure, a barrier membrane should be placed before chest closure.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cirurgia Torácica / Tórax em Funil / Cardiopatias Congênitas / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: Ann Thorac Surg Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cirurgia Torácica / Tórax em Funil / Cardiopatias Congênitas / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Diagnostic_studies Limite: Humans Idioma: En Revista: Ann Thorac Surg Ano de publicação: 2023 Tipo de documento: Article