Evaluation of Intraoperative Cardiovascular Responses to Closed Repair for Pectus Excavatum

OBJECTIVE: Closed repair of pectus excavatum (PE), also known as the Nuss procedure, has become more popular recently, and whether this operation results in true cardiac improvement as opposed to postoperative physical rehabilitation or a psychological effect deserves examination. METHODS: Ten PE patients (8 males, 2 females) aged 4 to 54 years (average, 19.6+/- 14 years) were prospectively evaluated using preoperative computed tomography (CT) scan, pulmonary function studies, electrocardiogram and transthoracic echocardiographic (TTE) evaluation of cardiac function. The same studies were repeated at 3 months post bar placement. In addition, intraoperative transesophageal echocardiogram (TEE) was done to measure the procedure-related values of the cardiac chamber and functional indices before and after turning of the pectus bar. RESULTS: Statistically significant changes in the pectus index, obtained by dividing the internal transverse distance of the thorax by the vertebral-sternal distance at the most depressed portion of the deformity, were noted after surgery, decreasing from 5.06+/-1.46 to 3. 55+/-0.48 (P<0.05). Most patients with previously abnormal electrocardiograms showed a normal pattern after surgical repair (P