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Semin. Pediatr. Surg. · Jun 2018
ReviewNuss procedure in the adult population for correction of pectus excavatum.
- Cristine S Velazco, Reza Arsanjani, and Dawn E Jaroszewski.
- Department of Cardiovascular and Thoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States.
- Semin. Pediatr. Surg. 2018 Jun 1; 27 (3): 161-169.
AbstractMinimally invasive repair of pectus excavatum has been successfully modified for use in adult patients. Many patients present in adulthood with progression of symptoms as the chest wall becomes less compliant with age. A thorough workup is completed including echocardiogram and chest CT to evaluate for anatomic abnormalities. Cardiopulmonary exercise testing is done to quantify the physiologic impact. Modifications of the original Nuss procedure required to allow for successful adult repair include the use of forced sternal elevation, the use of multiple bars, medial bar fixation, and interspace support to prevent bar rotation and migration. Occasionally, fractures may occur that require an open procedure and osteotomy or cartilage resection and hybrid approach incorporating the principals of intrathoracic support and osteotomy with bar stabilization.Copyright © 2018. Published by Elsevier Inc.
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