Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지
DOI QR코드

DOI QR Code

Repair of Recurrent Pectus Excavatum with a Huge Chest Wall Defect in a Patient with a Previous Ravitch and Pectus Bar Repair: A Case Report

  • Rim, Gongmin (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Hyung Joo (Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • Received : 2021.07.29
  • Accepted : 2021.12.14
  • Published : 2022.06.05
Download PDF
⟨ Previous Next ⟩

Abstract

Recurrent pectus excavatum (PE) after a Ravitch operation is not uncommon. Extensive costal cartilage resection from the previous Ravitch procedure can lead to an irregular, unstable chest wall depressions with a varying degree of deformity. The optimal approach to cover the chest wall defect and remodel the deformity, remains unknown. We report the case of a 27-year-old woman seeking surgery for the third time for recurrent PE. The patient presented with 2-time recurrent pectus excavatum following a failed Ravitch procedure and subsequent pectus bar repair. The entire chest wall reconstruction and remodeling entailed covering the chest wall defect with 2 titanium plates across both sides of the rib cage, and lifting and fixing the depressed chest wall with 2 parallel pectus bars.

Keywords

References

  1. Jaroszewski DE, Ewais MM, Lackey JJ, et al. Revision of failed, recurrent or complicated pectus excavatum after Nuss, Ravitch or cardiac surgery. J Vis Surg 2016;2:74. https://doi.org/10.21037/jovs.2016.03.17
  2. Johnson KN, Jaroszewski DE, Ewais M, Lackey JJ, McMahon L, Notrica DM. Hybrid technique for repair of recurrent pectus excavatum after failed open repair. Ann Thorac Surg 2015;99:1936-43. https://doi.org/10.1016/j.athoracsur.2015.02.078
  3. Sacco Casamassima MG, Papandria D, Goldstein SD, et al. Contemporary management of recurrent pectus excavatum. J Pediatr Surg 2015;50:1726-33. https://doi.org/10.1016/j.jpedsurg.2015.04.013
  4. Redlinger RE Jr, Kelly RE Jr, Nuss D, Kuhn MA, Obermeyer RJ, Goretsky MJ. One hundred patients with recurrent pectus excavatum repaired via the minimally invasive Nuss technique: effective in most regardless of initial operative approach. J Pediatr Surg 2011;46:1177-81. https://doi.org/10.1016/j.jpedsurg.2011.03.048
  5. Miller DL. Reoperative pectus repair using biomaterials. Ann Thorac Surg 2020;110:383-9. https://doi.org/10.1016/j.athoracsur.2020.02.070
  6. Stearns JD, Twaibu J, Kwaku D, et al. Efficacy of standard chest compressions in patients with Nuss bars. J Thorac Dis 2020;12:4299-306. https://doi.org/10.21037/jtd-20-702