Hybrid Technique for Repair of Recurrent Pectus Excavatum After Failed Open Repair

Revision of Failed Prior Nuss in Adult Patients With Pectus Excavatum

“…In addition, when it was available, we obtained information regarding prior procedures that were performed at outside institutions. All patients who underwent a previous Ravitch or open-type PE repair were excluded because of the complexity of recurrences [26].…”

“…Once elevation was achieved, pectus support bars were placed as in the modified MIRPE approach. Osteotomies of the sternum, sternal costal-cartilage attachments, or relaxing incisions were performed only at sites preventing elevation [6,26]. The pectus support bars were then placed and secured with thoracoscopic guidance, as previously described (Fig 6).…”

Nuss procedure for repair of pectus excavatum after failed Ravitch procedure in adults: indications and caveats

“…Nuss procedure for repair of pectus excavatum after failed Ravitch procedure in adults: indications and caveats premature strut removal), malunion and many more. Several techniques including open approaches, minimally invasive as well as hybrid techniques have been described for repair of recurrent PE, with minimally invasive techniques being predominantly used in children and young adults only (6)(7)(8)(9)(10)(11). Aim of the present series was to investigate the efficacy and safety of the minimally invasive Nuss procedure for repair of recurrent PE after prior Ravitch surgery in adults.…”

Revision of failed, recurrent or complicated pectus excavatum after Nuss, Ravitch or cardiac surgery

“…Complex open repairs were required in many adult patients after prior open repair when compared to other studies (18)(19)(20). In our own experience of repairs after recurrent open procedures, a hybrid technique was utilized to optimize repair in over 70% of patients (22). Follow up on all studies is limited and the long-term durability of repairs unknown.…”

“…Recurrences following open repair can also be associated with osteonecrosis, malunion and chest wall hernia ( Figure 2) (1,6,18,20,21). Open repair and stabilization is recommended for these types of complex issues (18,22).…”