Changes in thoracic cavity dimensions of pectus excavatum patients following Nuss procedure

Rha, Eun Young; Kim, Jun Hyeok; Yoo, Gyeol; Ahn, Seha; Lee, Jun; Jeong, Jin Yong

doi:10.21037/jtd.2018.06.159

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…After correction of anterior depression of the sternum, compensatory narrowing of chest width was observed. Changes in thoracic dimensions following the Nuss procedure were distinct in patients aged above 13 years [5]. In the present case, the patient underwent Nuss operation at the age of 3.…”

Section: Discussionmentioning

confidence: 52%

“…Supraventricular and ventricular arrhythmia often occur regardless of chest repair operation (Nuss operation), which is caused by compression of the anterior sternal wall [1][2][3][4]. In addition, repair operation of pectus excavatum can change thoracic cavity dimension and geometry [5]. It might cause several challenges of catheter ablation for supraventricular tachyarrhythmias.…”

Section: Introductionmentioning

confidence: 99%

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Embarrassed Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Pectus Excavatum

Lee¹,

Ban²

2022

Ewha Med J

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A 16-year-old patient with pectus excavatum visited our hospital because of palpitation. He underwent first Nuss operations at the age of 3. When he was 13 years old, the slow-fast type atrioventricular nodal reentrant tachycardia was documented during electrophysiology study. However, the catheter ablation was not conducted because of recurrent atrial fibrillation during procedure. At that time, second Nuss operation was performed due to progressive chest wall deformity. And then, atrioventricular nodal reentrant tachycardia was successfully treated by radiofrequency catheter ablation at the higher position than usual slow pathway zone under the modified fluoroscopic view with the cranial angle although distorted right atrial geometry and radiographic obstacle of Nuss operation bar. The concern about abnormal cardiac and electrical anatomy, and the accurate and modified procedure technique are essential in patients with pectus excavatum. (Ewha Med J 2022;45(3):e6)

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Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Embarrassed Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Pectus Excavatum

Lee¹,

Ban²

2022

Ewha Med J

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“…As the most common chest wall abnormality, pectus excavatum accounts for more than 90% of all congenital chest wall abnormalities (1). Most patients are healthy and the most common symptoms include exercise intolerance, dyspnea, chest pain, or palpitations (2). The only physiologic explanation for these complaints is the compression of chest wall malformation to the lung and the heart, since the pulmonary parenchyma and airways of the lung are not generally diseased (4).…”

Section: Discussion Among Physicians From Local Hospitalsmentioning

confidence: 99%

Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report

Wang¹,

Yu²,

Zhang³

et al. 2020

J Thorac Dis

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Pectus excavatum (PE) is the most common chest wall deformity (1). Patients may complain of exercise intolerance, dyspnea, chest pain, or palpitations (2), severe symptoms like syncope are rare (3). Preoperative examinations could reveal distinct types of cardiac arrhythmia. However, there were no reports of combining with second-degree atrial-ventricular (AV) block (Mobitz II). Furthermore, pectus excavatum requiring temporary pacemaker implantation for the sake of a combination of the AV block before the operation was infrequent.We here presented a case of pectus excavatum combined with a second-degree AV block (Mobitz II), which also required a temporary pacemaker implantation before the Nuss procedure.We present the following case in accordance with the CARE reporting checklist (available at http://dx.doi.

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“…According to a previous study, the post-operative maximum transverse diameter is 95% of the pre-operative value [17]. The post-operative maximum transverse diameter (A') was derived by applying the results of the corresponding study.…”

Section: Validation Of Cad-based Patient-specific Nuss Bar Design Tecmentioning

confidence: 99%

Computer-Aided Design and Manufacturing Technology for Identification of Optimal Nuss Procedure and Fabrication of Patient-Specific Nuss Bar for Minimally Invasive Surgery of Pectus Excavatum

Kim¹,

Heo²,

Hoseok

et al. 2018

Applied Sciences

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The Nuss procedure is one of the most widely used operation techniques for pectus excavatum (PE) patients. It attains the normal shape of the chest wall by lifting the patient’s chest wall with the Nuss bar. However, the Nuss bar is for the most part bent by a hand bender according to the patient’s chest wall, and this procedure causes various problems such as the failure of the operation and a decreased satisfaction of the surgeon and patient about the operation. To solve this problem, we proposed a method for deriving the optimal operation result by designing patient-specific Nuss bars through computer-aided design (CAD) and computer-aided manufacturing (CAM), and by performing auto bending based on the design. In other words, a three-dimensional chest wall model was generated using the computed tomography (CT) image of a pectus excavatum patient, and an operation scenario was selected considering the Nuss bar insertion point and the post-operative chest wall shape. Then, a design drawing of the Nuss bar that could produce the optimal operation result was derived from the operation scenario. Furthermore, after a computerized numerical control (CNC) bending machine for the Nuss bar bending was constructed, the Nuss bar prototype was manufactured based on the derived design drawing of the Nuss bar. The Nuss bar designed and manufactured with the proposed method has been found to improve the Haller index (HI) of the pectus excavatum patient by approximately 37% (3.14 before to 1.98 after operation). Moreover, the machining error in the manufacturing was within ±5% compared to the design drawing. The method proposed and verified in this study is expected to reduce the failure rate of the Nuss procedure and significantly improve the satisfaction of the surgeon and patient about the operation.

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Changes in thoracic cavity dimensions of pectus excavatum patients following Nuss procedure

Abstract: Correction of anterior depression of the sternum and compensatory narrowing of the chest width were observed in PE patients following the Nuss procedure. Further research will be necessary to determine the relationship between these observations and postoperative changes in chest volume.

Cited by 6 publications

References 20 publications

Embarrassed Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Pectus Excavatum

Embarrassed Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Pectus Excavatum

Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report

Computer-Aided Design and Manufacturing Technology for Identification of Optimal Nuss Procedure and Fabrication of Patient-Specific Nuss Bar for Minimally Invasive Surgery of Pectus Excavatum

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