Corrective surgery for congenital heart disease combined with NUSS procedure for pectus excavatum as one staged operation

Abstract

Objective To investigate the clinical outcomes of combining corrective surgery for congenital heart disease (CHD) and NUSS surgery for pectus excavatum (PE) as one-staged operation. Methods From July 2006 to June 2010, 15 children with CHD associated with PE were recruited in this study, and divided into two groups: group A underwent one-staged and group B with twostaged operation. Group A had 8 patients including 5 males and 3 females, aging from 4 to 13.4 years (mean, 6 years and 1 month). Among the 8 patients, 6 with ventricular septal defect (VSD) and 2with atrial septal defect (ASD) underwent interventional or open repair. After the corrective surgery for their CHD, the 8 patients underwent NUSS procedure for pectus excavatum. The group B had 7patients, including 5 males and 2 females. Among them, 6 had VSD and 1 had tetralogy of fallot (TOF). At the first stage, the patients underwent corrective surgery to repair VSD and TOF under CPB. At the second stage, the patients were performed NUSS surgery to correct PE. Their ages at surgery were 4 years and 7 months to 8 years old (mean, 6 years and 2 months). Results All operations were finished successfully. The endotracheal tube was removed 5 to 14 hours after surgery on Group A patients (mean, 8.75 ± 2.59 h), and 4 to 8 hours on Group B patients (mean, 5.86 ±1. 24 h). The drainage tubes of pericardium, mediastinal or chest were removed 48 to 72 h later after surgery. The patients were followed up for 6 months to 4 years. No surgery-related death, hemorrhage, thoracic organ dysfunction and other severe complications were noted. Delayed wound healing was observed on 1 patient in each group. Others recovered from surgery and were discharged from the hospital. Conclusions It is safe to combine corrective surgery for CHD and NUSS procedure for PE as one stage operation. Key words: Pectus excavatum; Heart disease, congenital; Cardiopulmonary bypass