To view the entire topic, please log in or purchase a subscription.
STS Cardiothoracic Surgery E-Book from The Society of Thoracic Surgeons provides expert guidance for Cardiac and Thoracic Surgery. Sections include Pearson’s General Thoracic, Esphageal, Adult Cardiac, and Pediatric and Congenital Cardiac Surgery. Explore these free sample topics:
-- The first section of this topic is shown below --
Surgical trials to treat pectus excavatum began as early as 1911, when Meyer attempted to correct congenital sternal depression by sternocostal resection.[1]However, surgical treatment of this deformity became popular only after Ravitch in 1949 and our group in the 1960s recognized the pathophysiologic features of this disease and laid down the basic principles of surgical correction.[2],[3],[4]
These original techniques are still practiced by many, using a plethora of new methods-most of them based on modification of the same techniques. As it usually happens, new operations led to new complications, some of which were never before seen. These complications ranged from support-rod dislodgement to acquired restrictive thoracic dystrophy and, last but not least, true recurrence of the previously existing anomaly. More often than not, these complications were linked to particular faults in the technique of surgical repair.
The purpose of this chapter is to discuss the cause, prevention, consequences, and treatment of these iatrogenic conditions. Postoperative complications that are not specific to pectus deformity repair, such as incisional site infections, are not included in this chapter.
Complications occurring after pectus deformity repair can be classified as shown in Box 1.
Injury to the heart and great vessels Residual deformity Sternal rotation Acquired pectus carinatum Pneumothorax (after Nuss) and/or hemothorax Asymmetry and/or retarded growth of the breasts Floating sternum Sternal sequestration Keloid formation Psychological effects Peri-incisional numbness/pain Dislodgement or fracture of the substernal rods Allergy to metals Pericarditis-like syndrome Acquired scoliosis Thoracic outlet syndrome True recurrence of the pectus deformity |
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Surgical trials to treat pectus excavatum began as early as 1911, when Meyer attempted to correct congenital sternal depression by sternocostal resection.[1]However, surgical treatment of this deformity became popular only after Ravitch in 1949 and our group in the 1960s recognized the pathophysiologic features of this disease and laid down the basic principles of surgical correction.[2],[3],[4]
These original techniques are still practiced by many, using a plethora of new methods-most of them based on modification of the same techniques. As it usually happens, new operations led to new complications, some of which were never before seen. These complications ranged from support-rod dislodgement to acquired restrictive thoracic dystrophy and, last but not least, true recurrence of the previously existing anomaly. More often than not, these complications were linked to particular faults in the technique of surgical repair.
The purpose of this chapter is to discuss the cause, prevention, consequences, and treatment of these iatrogenic conditions. Postoperative complications that are not specific to pectus deformity repair, such as incisional site infections, are not included in this chapter.
Complications occurring after pectus deformity repair can be classified as shown in Box 1.
Injury to the heart and great vessels Residual deformity Sternal rotation Acquired pectus carinatum Pneumothorax (after Nuss) and/or hemothorax Asymmetry and/or retarded growth of the breasts Floating sternum Sternal sequestration Keloid formation Psychological effects Peri-incisional numbness/pain Dislodgement or fracture of the substernal rods Allergy to metals Pericarditis-like syndrome Acquired scoliosis Thoracic outlet syndrome True recurrence of the pectus deformity |
There's more to see -- the rest of this entry is available only to subscribers.