Cardiac Perforation Caused By Pectus Excavatum Metal Bar Stabilizer: A Case Report.

Alexandre De Oliveira, Marco Antonio P Oliveira, Rafael Ribeiro Barcelos, Diego Arley Gomes da Silva, Miguel Lia Tedde
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Abstract

This paper reports the case of a female patient who underwent minimally invasive repair of pectus excavatum (MIRPE) in another service that evolved with bar rotation and cardiac perforation caused by the left stabilizer. The unique and frightening aspect of the case is that despite having the stabilizer inside the ventricle, the patient was oligosymptomatic: occasional chest pain and respiratory discomfort. Preoperative imaging showed rotation of the bar with stabilizers within the thoracic cavity. During surgery, intense ossification was observed around the prosthesis and it was noted that the left stabilizer had perforated the patient's left ventricle. Cardiac repair required a Clamshell incision and cardiopulmonary bypass. This case reinforces the validity of late radiological follow-up after MIRPE in an attempt to avoid this type of event, and the need to reevaluate the use of stabilizers perpendicular to the bar since they are not safe to prevent rotation of these implants.

胸大肌金属棒稳定器导致心脏穿孔:病例报告。
本文报告了一例女性患者的病例,她在另一家医院接受了开胸肌微创修复术(MIRPE),术后出现了左侧稳定器引起的横杆旋转和心脏穿孔。该病例的特殊性和可怕之处在于,尽管稳定器位于心室内部,但患者却没有任何症状:偶尔出现胸痛和呼吸道不适。术前造影显示,胸腔内有稳定器的横杆旋转。手术中观察到假体周围有严重骨化,并注意到左侧稳定器已穿透患者的左心室。心脏修复手术需要蛤壳式切口和心肺旁路。该病例证明了在 MIRPE 术后进行晚期放射学随访以避免此类事件发生的有效性,同时也证明了重新评估使用与横杆垂直的稳定器的必要性,因为这种稳定器在防止假体旋转方面并不安全。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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