Cardio-Pulmonary function in adolescents with Pectus Excavatum and the impact of surgical intervention

Abstract

Background: It is known that some people with Pectus Excavatum (PE) have impaired lung and cardiac function. Surgical correction by the Nuss procedure is becoming more common and as well as improving the aesthetics of the chest it may potentially improve any cardio-respiratory impairment. Objectives: We aimed to determine the occurrence of impaired cardio-pulmonary function in adolescents with PE. We aimed to assess for any improvement in physiological function 1 year post Nuss repair in a group of patients who underwent surgery. Methods: We retrospectively analysed pulmonary function and cardiopulmonary exercise testing (CPET) results in patients with PE. We looked for a statistically significant difference 1 year post Nuss in a variety of parameters. Results: 27 adolescents (21 male) with PE had pulmonary function and CPET. 30% had evidence of restrictive lung function. 56% had a reduced aerobic capacity (VO2peak) and 81% had a reduced Oxygen pulse. Only 15% had evidence of ventilatory limitation during CPET. Table 1 shows demographics and summary results. Conclusion: A significant number of adolescents with PE will have impaired cardio-pulmonary function. However ventilatory limitation is not the limiting factor in the majority of patients during CPET. Nuss repair may improve lung volumes and cardiac function 1 year post surgery.