Importance of Morphological Findings in the Progress and Treatment of Chest Wall Deformities with Special Reference to the Value of Computed Tomography, Echocardiography and Stereophotogrammetry*

Abstract

Patients with chest wall deformities have many particular anatomical, physiological, genetic, biomechanical and psychological characteristics. It is generally recognized that surgical correction of funnel chest and pigeon breast may be done for psychosocial reasons alone. Morphological and dynamic investigations are done to identify the function of the deformed chest wall and to permit objective assessment of the cosmetic and functional outcomes of the operation. There is no universally agreed standard for the diagnosis of funnel chest and pigeon breast. Non-invasive investigations, such as computed tomography (CT), echocardiography (ECG) and stereophotogrammetry (SP), improve the quality of the diagnostic assessment, including evaluation of its functional aspects, without directly influencing the decision to operate, which is still made mainly on subjective grounds. The value of these techniques in the diagnosis of chest wall deformities is assessed and the results of our personal experience are presented.

Ventilatory and Cardiovascular Responses to Exercise in Patients With Pectus Excavatum

“…Garusi and D'Ettore 52 found through the use of cardiac angiography that, while the heart was shifted to the left, the dimensions of the cardiac chambers were essentially normal. 53 Beiser et al 8 performed cardiac catheterization on three patients before and after corrective surgery, and found that cardiac output during intense upright exercise was below the normal range in two patients and was at the lower limits in the third patient. However, because of the small sample size it is difficult to draw generalizations based on these findings.…”

Evaluation of Intraoperative Cardiovascular Responses to Closed Repair for Pectus Excavatum

“…In 1962, Bevegård [18] performed cardiac catheterization in 16 patients with PE. The dimensions of the cardiac chambers measured by cardiac catheterization were basically normal in PE [19]. Wynn et al [8] studied the cardiovascular response to exercise in 13 PE patients and found no significant difference in cardiac output at exercise between patients who had undergone surgical repair and patients who did not have corrective surgery.…”

Surgical correction of pectus excavatum: the Münster experience

“…Decreased right-ventricular filling due to impaired function of the right atrium is also responsible for the reduced stroke volume during exercise [16]. Preoperative echocardiographic and Doppler findings have also correlated well with the extent of cardiac displacement [17]. A significant increase in the cardiac index after operation is evident when patients performed exercises in the sitting position, presumably on the basis of an increased stroke volume.…”