Exceptional life-threatening complication 19 years after Ravitch correction of pectus excavatum.


Journal

Journal of cardiac surgery
ISSN: 1540-8191
Titre abrégé: J Card Surg
Pays: United States
ID NLM: 8908809

Informations de publication

Date de publication:
Oct 2021
Historique:
revised: 13 06 2021
received: 04 05 2021
accepted: 11 07 2021
pubmed: 3 8 2021
medline: 14 9 2021
entrez: 2 8 2021
Statut: ppublish

Résumé

Ravitch technique of chest correction has been considered, although invasive, as a safe and efficacious surgical method. We describe a case of a 35-year-old woman with cardiac tamponade and in cardiogenic shock due to exceptional late complication after pectus excavatum reconstruction by means of classic Ravitch technique 19 years earlier. This very late adverse event was caused by a broken metal sternal wire that injured the wall of the ascending aorta. The patient underwent salvage repair of this segment of the aorta in cardiopulmonary bypass. Postoperative course and postdischarge 3-year follow-up have been uneventful. Therefore, life-threatening cardiovascular complications may occur even many years after reconstructive surgery for chest deformity.

Sections du résumé

BACKGROUND BACKGROUND
Ravitch technique of chest correction has been considered, although invasive, as a safe and efficacious surgical method.
CASE METHODS
We describe a case of a 35-year-old woman with cardiac tamponade and in cardiogenic shock due to exceptional late complication after pectus excavatum reconstruction by means of classic Ravitch technique 19 years earlier. This very late adverse event was caused by a broken metal sternal wire that injured the wall of the ascending aorta. The patient underwent salvage repair of this segment of the aorta in cardiopulmonary bypass. Postoperative course and postdischarge 3-year follow-up have been uneventful.
CONCLUSION CONCLUSIONS
Therefore, life-threatening cardiovascular complications may occur even many years after reconstructive surgery for chest deformity.

Identifiants

pubmed: 34339529
doi: 10.1111/jocs.15889
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

3971-3972

Informations de copyright

© 2021 Wiley Periodicals LLC.

Références

Obermeyer RJ, Goretsky MJ. Chest wall deformities in pediatric surgery. Surg Clin North Am. 2012;92:669-684. https://doi.org/10.1016/j.suc.2012.03.001
Brochhausen C, Turial S, Müller F, et al. Pectus excavatum: history, hypotheses and treatment options. Interact Cardiovasc Thorac Surg. 2012;14:801-806. https://doi.org/10.1093/icvts/ivs045
Harris C, Croce B, Cao C. Pectus excavatum. Ann Cardiothorac Surg. 2016;5(5):528. https://doi.org/10.21037/acs.2016.08.07
Kanagaratnam A, Phan S, Tchantchaleishvilli V, Phan K. Ravitch versus Nuss procedure for pectus excavatum: systematic review and meta-analysis. Ann Cardiothorac Surg. 2016;5:409-421. https://doi.org/10.21037/acs.2016.08.06
Jemielity M, Pawlak K, Piwkowski C, Dyszkiewicz W. Life-threatening aortic hemorrhage during pectus bar removal. Ann Thorac Surg. 2011;91:593-595. https://doi.org/10.1016/j.athoracsur.2010.07.041
Monica MP, Merkely B, Szilveszter B, Drobni ZD, Maurovich-Horvat P. Computed tomographic angiography for risk stratification in patients with acute chest pain-the triple rule-out concept in the emergency department. Curr Med Imaging Rev. 2020;16:98-110. https://doi.org/10.2174/1573405614666180604095120

Auteurs

Krzysztof Greberski (K)

Department of Cardiac Surgery, J Strus Multidisciplinary Hospital, Poznan, Poland.
Department of the Prevention of Cardiovascular Diseases, Faculty of Health Sciences, Poznan University of Medical Sciences, Poznan, Poland.

Radosław Jarząbek (R)

Department of Cardiac Surgery, J Strus Multidisciplinary Hospital, Poznan, Poland.

Bartłomiej Perek (B)

Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.

Maciej Łuczak (M)

Department of Medical, Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland.

Paweł Bugajski (P)

Department of Cardiac Surgery, J Strus Multidisciplinary Hospital, Poznan, Poland.
Department of the Prevention of Cardiovascular Diseases, Faculty of Health Sciences, Poznan University of Medical Sciences, Poznan, Poland.

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