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Operative Management of Pectus Arcuatum: a Minimally-Invasive Approach.
Ann Schwentker, MD
Nathaniel Roberson, MD
Rebeccah Brown, MD
Victor Garcia, MD
University of Cincinnati
2022-01-29
Presenter: Nathaniel Roberson
Affidavit:
Agree with the above statement.
Director Name: Ann Schwentker, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background/Purpose
Pectus arcuatum is a chest wall deformity accounting for less than 1% of pectus cases. Nuss bar placement is standard of care for treatment of other pectus deformities. Nuss bar placement in pectus arcuatum can result in worsening of the deformity. Currently, pectus arcuatum is managed with open resection of the costal cartilages as popularized by Ravitch. The purpose of this study is to report a minimally-invasive approach involving anterior wedge osteotomy of the sternum and contouring of the prominent costal cartilages for the surgical management of pectus arcuatum.
Methods
A retrospective review of all patients with pectus arcuatum managed with a minimally-invasive surgical approach at our institution from 2018 to 2021 was performed. Demographic data, presenting symptoms, surgical treatment, complications, and outcomes were collected.
Results
Six patients, four (66.7%) male, ages 11-19 (mean 14.7) at time of surgery were included in the study. Average pre-operative Haller index was 3.7. Four (66.7%) of the patients reported symptoms related to activity including chest pain and/or shortness of breath with all reporting improvement in symptoms after the procedure. Two (33.3%) of the patients had previous Nuss bar placement without improvement in symptoms or cosmesis. Two (33.3%) of the patients did not require sternal osteotomy for correction of the chest deformity. No post-operative complications were reported. All patients reported subjectively improved cosmesis.
Conclusion
The described minimally-invasive surgical procedure performed for correction of pectus arcuatum results in subjectively improved symptoms and cosmetic appearance and is associated with a low rate of complications.
