F-031THE IMPROVEMENT OF EXERCISE CAPACITY AFTER SURGICAL CORRECTION OF PECTUS CARINATUM IS ASSOCIATED WITH REVERSAL OF DYNAMIC HYPERINFLATION

Abstract

There is contradictory evidence regarding improvement in dyspnoea and exercise tolerance following corrective surgery for pectus carinatum. It is even more unclear as to the mechanism of any improvement. Thus we observed the changes in chest wall function in response to an incremental load exercise before and after surgery. Methods: Using optoelectronic plethysmography, total and regional chest wall volumes were measured in 3 male patients with pectus carinatum who underwent a Ravitch procedure. Rib cage and abdominal volumes were recorded at rest and during exercise (incremental cycle ergometry), before and after surgery in conjunction with spirometry. Results: Our results shows that the end expiratory volume (EEV) in these patients increased by 14 ± 0.4% compared to quiet breathing during maximal exercise before surgery (P < 0.002). This air trapping during exercise or dynamic hyperinflation was corrected after surgery. Postoperatively their EEV decreased during 100% exercise by 2.3 ± 1.4% at 5 months respectively (P 0.001). The end inspiratory volume did not change significantly. This was associated with a 38% increase in exercise time 5 months after surgical correction (P< 0.05). Conclusions: This is the first published data to show dynamic hyperinflation in pectus carinatum patients and the beneficial effects of corrective surgery. This was associated with a significant improvement in exercise capacity after surgery. Therefore, we conclude that improvement in exercise capacity early after surgery is likely due to correction of dynamic hyperinflation. The longer term effects on chest wall function are yet to be defined. Disclosure: No significant relationships.