Simultaneous surgical strategy for pectus excavatum and concurrent congenital heart defects in children

Q4 Medicine

中华小儿外科杂志 Pub Date : 2020-02-15 DOI:10.3760/CMA.J.ISSN.0253-3006.2020.02.011

Guangxian Yang, Liwen Yi, Ji-Feng Xiang, Jinhua Wang, Xicheng Deng

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引用次数: 0

Abstract

Objective To explore the optimal surgical strategy for children with pectus excavatum (PE) and concurrent congenital heart defect (CHD). Methods From July 2007 to May 2018, retrospective reviews were conducted for medical records of 17 children undergoing simultaneous repair of PE with concurrent CHD.There were 10 boys and 7 girls with an average age of (4.5±2.7)(1-12.7) years and an avergae body weight of (14.5±5.2)(7.5-27.5) kg.There were simple ventricular septum defect (VSD, n=4), simple atrial septum defect (ASD, n=8), VSD & ASD (n=3), VSD & ASD & patent ductus arteriosus (PDA, n=1) and VSD with pulmonary hypertension (n=1). For repairing PE, open sternal elevation was performed with liberating tissue from posterior sternum, lifting sternum by wires, Nuss plating and a custom-made sternal lifting device.CHD was corrected by open heart surgery via cardiopulmonary bypass or transcatheter closure under echocardiography or radiology-guided percutaneous intervention. Results Among them, the operations led to satisfactory repair of both conditions without serious complications.All parents and children were satisfied with postoperative chest appearances.The mean duration of hospitalization was (13.6±4.8)(8-25) days.The postoperative complications were delayed wound healing (n=2) and minimal left pleural effusion (n=1). There was no occurrence of such severe complications as surgical mortality, major hemorrhage, chest organ injuries or implant rejection. Conclusions According to the characteristics of patients, individualized approaches are selected for correcting PE and concurrent CHD.Both safe and effective, such a strategy avoids the risks of multiple operations and anesthesia and the outcomes are satisfactory. Key words: Funnel chest; Heart diseases, congenital; Child

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儿童漏斗胸并发先天性心脏缺陷的同步手术策略

目的探讨儿童漏斗胸合并先天性心脏缺损(CHD)的最佳手术策略。方法回顾性分析2007年7月至2018年5月17例PE合并冠心病患儿的医疗记录。男10例，女7例，平均年龄(4.5±2.7)(1 ~ 12.7)岁，平均体重(14.5±5.2)(7.5 ~ 27.5)kg。单纯性室间隔缺损(VSD, n=4)、单纯性房间隔缺损(ASD, n=8)、室间隔缺损合并ASD (n=3)、室间隔缺损合并ASD合并动脉导管未闭(PDA, n=1)、室间隔缺损合并肺动脉高压(n=1)。对于PE的修复，开放胸骨上抬，从胸骨后部解放组织，用钢丝、Nuss钢板和定制的胸骨提升装置提起胸骨。在超声心动图或放射引导下经皮介入下，通过体外循环或经导管关闭的心脏直视手术纠正冠心病。结果两组患者术后均修复满意，无严重并发症。所有家长和孩子对术后胸部外观满意。平均住院时间为(13.6±4.8)(8 ~ 25)d。术后并发症为伤口愈合延迟(n=2)和少量左胸腔积液(n=1)。无手术死亡率、大出血、胸器官损伤、植入物排斥反应等严重并发症发生。结论根据患者的特点，选择个体化方法矫正PE合并冠心病。该策略安全有效，避免了多次手术和麻醉的风险，效果满意。关键词:漏斗箱;心脏病、先天性;孩子

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来源期刊

中华小儿外科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.40

自引率

0.00%

发文量

8707

期刊介绍： Chinese Journal of Pediatric Surgery is an academic journal sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. The journal was founded in 1980 and is included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences) and CSCD Chinese Science Citation Database Source Journal (including extended version). It is one of the national key academic journals under the supervision of the China Association for Science and Technology. Chinese Journal of Pediatric Surgery enjoys a high reputation and influence in the academic community. The articles published in this journal have a high academic level and practical value, providing readers with a large number of practical cases and industry information, and have received widespread attention and citations from readers.