Simultaneous Repair of Pectus Excavatum and Congenital Heart Defects
Tsutomu Hataoka, Yoshikiyo Matsunaga, Toru Okamura, Shinya Shimoyama, Akito Hamajima, Yoshie SasakiObjective
Pectus excavatum is a congenital chest wall deformity characterized by anterior chest wall depression and can be observed in patients undergoing cardiac surgery. Historically, simultaneous repair of congenital heart defects and pectus excavatum has been avoided due to potential risks and complications. This study aimed to evaluate the safety and feasibility of simultaneous repair of congenital heart defects and pectus excavatum using the Nuss procedure.
Methods
This retrospective study reviewed 5 patients who underwent cardiac surgery concurrently with the Nuss procedure (Group A) and 142 patients who underwent only the Nuss procedure (Group B) between September 2000 and November 2021 at our institution. We compared the pre- and postoperative Haller index, operative time for the Nuss procedure, and the incidence of Nuss bar-related complications between Groups A and B.
Results
No complications related to the Nuss procedure, such as infection, bar displacement, cardiac injury, or recurrence of pectus excavatum, occurred in Group A. There were no statistically significant differences between the 2 groups in pre- and postoperative Haller index, Nuss operative time, or complication rates. No operative or late deaths occurred during the follow-up period in either group.
Conclusions
Simultaneous repair of congenital heart defects and pectus excavatum using the Nuss procedure appears to be feasible and does not seem to increase the risk of Nuss bar-related complications compared with isolated repair. While further studies are needed to evaluate the advantages of this strategy, this combined approach may be considered for carefully selected cardiac surgery candidates with severe pectus excavatum.