Surgical Repair of Pectus Arcuatum

Background. Pectus arcuatum, a very rare variant (chondromanubrial) of the carinatum chest wall deformity, occurs due to premature fusion of the sternal ossification centers causing obliteration of the manubrio-sternal joint. Typically, patients undergo surgical repair for cosmetic purposes. This study reviews the clinical experience using titanium plate systems for surgical repair of pectus arcuatum. Methods. The records of our prospective Chest Wall Deformities Clinical Database since September 2018 include 27 pectus arcuatum patients. The patients aged 17 and older were evaluated for corrective surgery (n=24, 16 male, 8 female, mean age: 24.9 years). The hybrid surgical technique included wedge osteotomy of the most protruded part of the sternum, excision of the associated costochondral junctions followed by placement of two parallel titanium plates to secure the sternum, and insertion of an excavatum bar (n=7) if there is a significant depression at the sternal body. Follow-up outpatient visits were every 3 to 6 months. Results. All of the patients tolerated the surgery very well. The mean length of the surgery was 118 minutes. The mean hospital length of stay was 5.6 days. One patient experienced pericardial and right pleural effusion two weeks after surgery, which was resolved by anti-inflammatory treatment. The mean time to return to daily activity was 12 days. The mean follow-up was 42 months. All patients indicated the postoperative results as very good or excellent. Conclusions. Repair of arcuatum deformity can be performed in adults with low morbidity, short hospital stay, and satisfactory cosmetic results even in complex cases.