Abstract
Introduction Minimally invasive repair for pectus excavatum (MIRPE) is controversial in extremely severe cases of pectus excavatum (PE) and an open repair is usually favored. Our aim is to describe a case of a patient with an extremely severe PE that underwent a minimally invasive approach. Case report An 8-year-old girl with severe sternum depression was assessed. She had a history of exercise intolerance, nocturnal dyspnea, fatigue, and shortness of breath. Chest computed tomography showed that sternum depression was posterior to the anterior vertebral column; therefore, Haller and correction index could not be measured. Spirometry indicated an obstructive ventilation pattern (forced expiratory volume in 1 second = 74.4%), and echocardiogram revealed a dilated inferior vena cava, mitral valve prolapse with normal ventricular function. After multidisciplinary committee evaluation, a MIRPE approach was performed. All symptoms had disappeared at the 3-month postoperative follow-up; the desired sternum shape was achieved and normalization of cardiopulmonary function was observed. The Nuss bars were removed after a 2-year period. After 18-month follow-up, the patient can carry out normal exercise and is content with the cosmetic result. Conclusion Nuss procedure is feasible in our 8-year-old patient. In this case, both the Haller and correction index were not useful to assess the severity of PE. Therefore, under these circumstances, other radiologic parameters have to be taken into consideration for patient evaluation.
Highlights
Invasive repair for pectus excavatum (MIRPE) is controversial in extremely severe cases of pectus excavatum (PE) and an open repair is usually favored
Chest computed tomography showed that sternum depression was posterior to the anterior vertebral column; Haller and correction index could not be measured
Nuss procedure is feasible in our 8-year-old patient
Summary
Invasive repair for pectus excavatum (MIRPE) is controversial in extremely severe cases of pectus excavatum (PE) and an open repair is usually favored. Pectus excavatum (PE) is the most common anterior chest wall deformity.[1,2,3] The indication of surgical correction is based on the severity of the deformity, its progression, symptoms, functional testing, and the psychosocial effects on the patient.[4,5] the age of repair has been considered controversial, currently the indication of repair at any age is based primarily on the degree of the deformity and symptoms with evidence of cardiac and/or pulmonary compression.[6] The minimally invasive repair for pectus excavatum (MIRPE) was first described by Nuss in 1998.4,7,8 Since its use has spread worldwide, modifications have been issued, and it is currently the procedure of choice in the correction of PE. The aim of this article is to describe the case of a patient with an extremely severe PE that underwent a minimally invasive approach, as well as the difficulties in assessing PE severity
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
