Normalized Cardiopulmonary Exercise Function in Patients With Pectus Excavatum Three Years After Operation

Maagaard, Marie; Tang, Mariann; Ringgaard, Steffen; Nielsen, Henning Overgaard; Frøkiær, Jørgen; Haubuf, Maj; Pilegaard, Hans K.; Hjortdal, Vibeke E.

doi:10.1016/j.athoracsur.2013.03.034

Cited by 95 publications

(84 citation statements)

References 22 publications

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“…Two additional studies (14,20) adjusted for growth during the study period by calculating the stroke index and reported improvements of 19% and 69% after surgical correction. Focusing on the right ventricle, three studies (5,16,18) revealed increasing right ventricular end-diastolic diameters ranging from 10% to 71%, whereas one study reported no change. Other right ventricular measurements also showed a similar pattern.…”

Section: Cardiac Function At Restmentioning

confidence: 99%

“…Ann Cardiothorac Surg 2016;5(5):485-492 www.annalscts.com the general conclusion on surgical impact is clouded by the diverse pulmonary and cardiac outcomes (5)(6)(7)(8). Perhaps for that reason, no clear consensus exists on the indication for operating on the PE patient-is it purely a cosmetic surgery or does the patient also benefit physiologically?…”

Section: Introductionmentioning

confidence: 99%

“…At our institution, the most recent (5) of the two studies, we found an increase in peak stroke index of 19%, whereas the study from 1985 by Peterson et al found no change. The cardiac index was measured by three studies (5,20,27), with one demonstrating increases of 23% following the Nuss-bar removal and two studies displaying no difference following surgery.…”

Section: Cardiac Function During Exercisementioning

confidence: 99%

“…In literature, the results on pulmonary function are generally inconclusive (4), whereas cardiac parameters tend to point towards improved cardiac function after correction (5). However, most studies include both pulmonary and cardiac parameters and thereby © Annals of Cardiothoracic Surgery.…”

Section: Introductionmentioning

confidence: 99%

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Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature

Maagaard

Heiberg

2016

Ann. Cardiothorac. Surg.

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Patients with pectus excavatum (PE) often describe improvements in exercise stamina following corrective surgery. Studies have investigated the surgical effect on physiological parameters; still, no consensus has yet been reached. Therefore, the aim of this literature review was to describe the cardiac outcome after surgical correction, both at rest and during exercise. In February 2016, a detailed search of the databases PubMed, Medline, and EMBASE was performed. We assessed clinical studies that described cardiac outcomes both before and after surgical correction of PE. We only included studies reporting either pre-defined echocardiographic or exercise test parameters. No exclusion criteria or statistical analyses were applied.Twenty-one full-text articles, published between 1972 and 2016, were selected, with cohort-ranges of 3-168 patients, mean age-ranges of 5-33 years, and mean follow-up-ranges from immediately to 4 years after surgery. Twelve studies described resting cardiac parameters. Four studies measured cardiac output, where one described 36% immediate increase after surgery, one reported 15% increase after Nuss-bar removal and two found no difference. Three studies demonstrated improvement in mean stroke volume ranges of 22-34% and two studies found no difference. Fifteen studies investigated exercise capacity, with 11 considering peak O 2 pr. kg, where five studies demonstrated improvements with the mean ranging from 8% to 15% after surgery, five studies demonstrated no difference, and one saw a decrease of 19% 3 months after Nuss-bar implantation. A measurable increase in exercise capacity exists following surgery, which may be caused by multiple factors. This may be owed to the relief of compressed cardiac chambers with the increased anteriorposterior thoracic dimensions, which could facilitate an improved filling of the heart. With these results, the positive physiological impact of the surgery is emphasized and the potential gain in cardiac function should be integrated in the clinical assessment of patients with PE.

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Section: Cardiac Function At Restmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Cardiac Function During Exercisementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature

Maagaard

Heiberg

2016

Ann. Cardiothorac. Surg.

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“…However, recent studies have refuted this statement and shown physiological improvement after surgical correction in the form of improved cardiac function (8)(9)(10), chest wall motion (11), and lung function (12). Nonetheless, cosmetic complaints are still the main indication for patients to undergo correction (13).…”

Section: Introductionmentioning

confidence: 96%

A prospective study on quality of life in youths after pectus excavatum correction

Lomholt

Jacobsen²,

Thastum

et al. 2016

Ann. Cardiothorac. Surg.

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Background: The impact of correction of pectus excavatum (PE) on adolescents' health-related quality of life (HRQL) has only been investigated in prospective designs using disease-specific measures and without controls. The aim of this prospective study was to evaluate the HRQL before and after surgical correction of PE using a generic HRQL measure, and to compare the reported level of HRQL before surgery with an age-comparable control group.Methods: Patients (n=107) and one of their parents (n=106) completed the generic HRQL measure: the Child Health Questionnaire before, 3 months, and 6 months after correction for PE. A control group (n=183) consisting of school children comparable in age completed the same measure on one occasion. Results:The patients' level of HRQL before surgery was comparable to the level of the controls except for physical functioning; here boys reported impaired function compared to controls (P<0.0001, d=0.72).Both patients and parents reported improved emotional wellbeing and self-esteem, as well as an increase in physical and social activities from pre-to post-surgery. These improvements were statistically significant (P≤0.001-0.03) and yielded moderate to high effect sizes (ƞ 2 =0.04-0.22). Conclusions:The improvement of physical and psychosocial HRQL reported by both patients and their parents as proxy indicates the psychological implications of the deformity. Patients reported impaired physical function compared to controls. Further, pre-surgery differences in HRQL between the patients and the controls were lacking. However, the improvement in the patients' HRQL following surgery may justify the correction of pectus excavatum. The effect of the deformity on patients wellbeing compared with controls' needs to be addressed in further studies.

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Pectus Excavatum: Functional Respiratory Impact, Quality of Life, and Preoperative Assessment

Daussy

Noël-Savina

Didier

et al. 2019

Pectus Excavatum and Poland Syndrome Surgery

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Normalized Cardiopulmonary Exercise Function in Patients With Pectus Excavatum Three Years After Operation

Cited by 95 publications

References 22 publications

Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature

Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature

A prospective study on quality of life in youths after pectus excavatum correction

Pectus Excavatum: Functional Respiratory Impact, Quality of Life, and Preoperative Assessment

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