Cardiopulmonary arrest during the <scp>N</scp>uss procedure: case report and review

Nakahara, Osamu; Ohshima, Shigeki; Baba, Hideo

doi:10.1002/ams2.110

Cited by 9 publications

(9 citation statements)

References 9 publications

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“…On the contrary, the presence of the bar prevents effective cardiac massage in the case of cardiac arrest and CPR maneuvers. Nakahara et al reported only emergent open‐chest cardiac massage may be effective, and the possibility of developing a new material, such as carbon fiber‐reinforced plastic, that not only deforms, but can also easily restore its shape as a bar material 10 …”

Section: Discussionmentioning

confidence: 99%

Combined robot‐assisted mitral valve plasty and Nuss procedure via small ports

et al. 2021

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Pectus excavatum (PE) can be associated with cardiac disorders that also require surgical repair. Totally endoscopic robot‐assisted mitral valve plasty for mitral valve regurgitation was performed while elevating the sternum with the aid of our original electrical sternum lifting system. Then, the Nuss procedure was performed successfully via small incision. Simultaneous robot‐assisted cardiac surgery and the Nuss procedure is effective. Sternal elevation during cardiac surgery is very important for a safe procedure. The Nuss technique prevents perioperative cardiac compression and allows for correction of the pectus deformity with good cosmetic and functional results.

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Section: Discussionmentioning

confidence: 99%

Combined robot‐assisted mitral valve plasty and Nuss procedure via small ports

et al. 2021

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“…Yet, there are very few reports of the use of CPR in patients with Nuss bars (16)(17)(18)(19). Although successful resuscitation occurred in a young adult with a single bar, there have been several case reports which describe the limitations of CPR for patients with one or more Nuss Bars (19)(20)(21)(22). A summary of these reports is presented in Table 2.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of standard chest compressions in patients with Nuss bars

Stearns¹,

Twaibu²,

Kwaku³

et al. 2020

J Thorac Dis

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Background: The Nuss procedure temporarily places intrathoracic bars for repair of pectus excavatum (PE). The bars may impact excursion and compliance of the anterior chest wall while in place. Effective chest compressions during cardiopulmonary resuscitation (CPR) require depressing the anterior chest wall enough to compress the heart between sternum and spine. We assessed the force required to perform the American Heart Association's recommended chest compression depth after Nuss repair. Methods: A lumped element elastic model was developed to simulate the relationship between chest compression forces and displacement with focus on the amount of force required to achieve a depth of 5 cm in the presence of 1-3 Nuss bars. Literature review was conducted for evidence supporting potential use of active abdominal compressions and decompression (AACD) as an alternative method of CPR. Results: The presence of bars notably lowered compression depth by a minimum of 69% compared to a chest without bar(s). The model also demonstrated a dramatic increase (minimum of 226%) in compressive forces required to achieve recommended 5 cm depth. Literature review suggests AACD could be an alternative CPR in patients with Nuss bar(s). Conclusions: In our model, Nuss bars limited the ability to perform chest compressions due to increased force required to achieve a 5 cm compression. The greater the number of Nuss bars present the greater the force required. This may prevent effective CPR. Use of active abdominal compressions and decompressions should be studied further as an alternative resuscitation modality for patients after the Nuss procedure.

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“…Despite association of pectus excavatum with cardiac abnormalities, the incidence of sudden cardiac arrest after MIRPE appears low [3,10]. Upon review of the literature just two case reports were found that described sudden cardiac arrest outside of the hospital after MIRPE [5,6]. Both patients received CPR and attempted defibrillation, however, both patients died (Table 1), again underlying the need for proper education of CPR providers caring for patients after MIRPE.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the relative prevalence of pectus excavatum, its association with cardiac anomalies, and the popularity of the MIRPE, there has been interest in the efficacy of cardiopulmonary resuscitation (CPR) in this population. Until now, successful CPR in a patient with a pectus bar has not been described [5,6]. We present the case of a 17-year-old male who underwent MIRPE at tertiary care children’s hospital, and prior to bar removal, experienced cardiac arrest with documented ventricular fibrillation followed by return of spontaneous circulation after successful CPR.…”

Section: Introductionmentioning

confidence: 99%