SESSION TITLE: Cardiothoracic Surgery SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2018 01:00 PM - 02:00 PM PURPOSE: Pectus anomaly contains always two components together, excavatum and carinatum portions, in a given deformity. For example, excavatum with lower costal flaring or carinatum with portions of depression. To treat all these components of pectus deformity in best quality, our approach has been “total remodeling” to treat all excavations and focal protuberances in pectus excavatum, carinatum, and all varieties of mixed forms. The purpose of this study is to illustrate the individual techniques for each specific component of the deformity, and to appraise the results. METHODS: We retrospectively analyzed the data of the total chest wall remodeling approach using pectus bars, which included 1153 patients with pectus excavatum and carinatum or mixed deformities between 2011 and 2016. Total remodeling approach represents all the components in a given deformity are treated in a single operative setting. The surgical techniques for the depressed chest wall was lifted with symmetric or asymmetric pectus bars in the fashions of single, parallel, or cross bars. The protruded part(s) of chest wall was compressed with the sandwich technique using the pectus bars or strings (flare-buster, magic string). RESULTS: The mean age of the patients was 10.1 years (3–55 years). The techniques used for the repair of excavatum portions were symmetric bar 779(67.6%), asymmetric bar 354(30.7%), single bar 679(58.9%), parallel bar 421(36.5%), cross-bar 33(2.9%), claw fixator 828(71.8%), hinge plate 395(34.3%), bridge connection 274(23.8%). The techniques used for the repair of carinatum portions were sandwich technique 20(1.7%), asymmetric bar 20(1.7%), bridge connection 20(1.7%), flare-buster 481(41.7%), magic string 51(4.4%). The major complication rates were: pneumothorax, 15 (1.3%); bar displacement, 6 (0.52%); pleural effusion, 27 (2.3%). There was no mortality. Reoperation was required in 10 patients (0.87%). The CT index changed after repair: Depression Index, 1.74 ± 0.67 to 1.00 ±0.00 (p<0.001), Asymmetry Index, 1.05 ± 0.22 to 0.97 ± 0.21 (p<0.001), Eccentricity Index, 1.45 ± 0.69 to 1.01 ±0.01 (p<0.001), and Unbalance Index, 1.13 ±0.27 to 1.02 ±0.01 (p<0.001). CONCLUSIONS: The total remodeling of the chest wall in repair of pectus deformity seemed to be effective in solving the morphological variations including pectus excavatum/carinatum complex and lower costal flare. With this concept, we achieved decent cosmetic outcomes in a single setting of surgery without residual deformities. CLINICAL IMPLICATIONS: Total chest wall remodeling strategy can be applied to treat the excavatum, carinatum, or mixed deformity with the combination of various repair techniques to fulfill a single-step comprehensive repair of the deformity. DISCLOSURES: No relevant relationships by Hyung Park, source=Web Response