Simultaneous repair for aortic incompetence with annuloaortic ectasia and pectus excavatum by modified Ravitch procedure with pectus bars in an adult patient with Marfan syndrome

Abstract

resection was recommended to prevent local tumor recurrence, even if this operation impaired the patient's quality of life (bypass, valve replacement, and ventricular septal defect patch closure). 2 Cases of cardiac transplantation to treat these fibromas have also been reported. 4 However, subtotal resection seems to be the best therapeutic option when the size or location of the tumor makes total resection impossible. The risk of tumor regrowth seems to be relatively low. Several colleagues have described the absence of tumor progression at long-term follow-up, even if the number of cases reported is low. Finally, transplantation does not seem to be an acceptable option, even with voluminous fibromas; subtotal resection should be the treatment of choice. 5 Even if it is widely accepted that fibromas should be totally resected because of their recurrence risk, subtotal surgical intervention might be an acceptable option when the volume or location of the tumor makes total resection a high-risk procedure.

Simultaneous Aortic Valve Replacement and Pectus Excavatum Correction in a 76-Year-Old Man

“…PE is likely to occur among patients with connective tissue disease such as Marfan syndrome, [5][6][7] but characteristic of Marfan syndrome, such as spider fingers and subluxation of the crystalline lens, was not detected in our case. In adult patients with PE, the clinical picture remains unclear because there are few published reports on the therapeutic management of PE in these patients.…”

“…[3][4][5] Staged operations were formerly recommended; 3) however, single-stage operations have been reported with favorable results in recent years. [4][5][6][7] We decided to perform simultaneous AVR and PE correction using the modified Ravitch procedure 6) to avoid any postoperative cardiopulmonary complications that may result from mechanical compression due to uncorrected sternal deformities. The patient was substantially relieved of his complaint; however, the single-stage operation using the modified Ravitch procedure induced excessive bleeding and a high-volume transfusion secondary to the prolonged operation time and postoperative recovery.…”

“…In these cases, staged operations were formerly recommended; 3) however, single-stage operations have been reported with favorable results in recent years. [4][5][6][7] In this case report, we present an adult patient who successfully underwent simultaneous aortic valve replacement (AVR) and PE correction using the modified Ravitch procedure and discuss surgical management for PE in adult patients.…”

Aortic surgery in Marfan patients with severe pectus excavatum

“…Six of the 27 articles were case series. 4,13,15,23,26,27 The majority of the reports were from East Asia, with 23 articles 7,9,14,16,20,21,24 (Supplementary File, http://links.lww.com/JCM/A84).…”

Simultaneous Surgical Correction of Pectus Excavatum and Cardiac Disease in Two Adults

“…Several procedures have been described for these purposes, including sternal elevation (e.g., Ravitch type procedure) and sternal plasty with median sternotomy for correction of chest deformity. [1][2][3][4] Patient 1 had undergone the initial mitral valve replacement via a median sternotomy without the correction of the funnel chest. We didn't have any information of severity of the funnel chest at the initial operation.…”