Technical Considerations in the Surgical Management of Pectus Excavatum and Carinatum

Atriyal Septal Defekt, Biküspit Aorta, Mental Reterdasyon ve Pektus Ekskavatum Birlikteliği: Olgu Sunumu

“…Kardiyak etkileri üç grupta toplanır; azalmış kardiyak output, artimiler ve mitral kapak prolapsusudur. Konjenital kalp defektleri ile pectus ekskavatumun birlite görülmesinin insidansı %0.17-0.50 arasındadır (16).…”

Pectus carinatum

“…Although hypoplasia of the diaphragmatic insertions into the sternum with hypotrophy of the lateral muscles of the chest has been suggested, it has not been confirmed by dissection performed in patients submitted to surgical correction. (1,2) Classification A) Lower PC Also known as chicken breast or pigeon breast, lower PC is the classical deformity characterized by a prominent sternum, principally in its median and lower portion, (19) almost always followed by lower bilateral costal depression, caused by the downward curve of costal cartilages and the ends of the ribs (Figure 1). A lateral view chest X-ray shows anterior protrusion of the sternum and manubriosternal joint, as well as evident division of the sternum into sternal notch, body (mesosternum), and xiphoid process.…”

“…The same author subsequently performed the fixation of the set formed by the xiphoid process and the straight abdominal muscles, at a level above, aiming at the traction of the sternum, helping maintain the sternum in its new rectified form. (1,20) Another author performed the subperichondrial resection of the cartilages involved, together with surgical fixation of the xiphisternal joint. (24) Other authors resected the cartilages involved, usually from the second to the seventh, performed single or multiple osteotomies, and fixed the new casting of the sternum with polypropylene sutures.…”

“…(24) Other authors resected the cartilages involved, usually from the second to the seventh, performed single or multiple osteotomies, and fixed the new casting of the sternum with polypropylene sutures. (25) In upper PC, a similar technique to that already used in PE (1) has been performed. (21) The technique consists of the subperichondrial resection of the cartilages involved, which, together with the intercostal muscles, are completely separated from the sternum.…”

“…The overall prevalence of these two deformities ranges from 0.6 to 0.97/1000 individuals, (1,2) and they are more common in men. In most published studies, PE is clearly predominant over PC, at a ratio ranging from 3:1 to 13:1.…”