234-ICARDIAC SURGERY AND REPAIR OF PECTUS DEFORMITIES: WHEN AND HOW?

article i nfo Objectives:There iscurrently alackofrecommendationsabout patientswith pectus deformitiesrequiring cardiac surgery. This study reports the results of our surgical strategy on this issue. Methods: Eleven patients, from three centers treated over a 9-year period were included in this study. Pectus de- formities were operated with a modified Ravitch procedure. In the case of pectus excavatum repair and concom- itant cardiac surgery, subperichondrial resection of abnormal rib cartilages was always performed before the sternotomy andaneasilyremovable retrosternalmetallicstrutwasinserted at theend of the procedureensuring anterior chest wall stability. During follow-up patients had to estimate their current appearance with a numeric scale ranging from 0 to 100. Results: Mean age was 27 ± 9.4 years. Pectus excavatum was present in 8 patients and pectus arcuatum in 3. There were 6 Marfan syndrome patients. Nine patients had concomitant surgery and, 2 underwent pectus repair after a history of cardiac surgery. There was no operative mortality. In the case of concomitant surgery, heart ex- posure through median sternotomy was facilitated by abnormal rib cartilage resection. Median follow-up was 54 months (range 16.7-119.7). Mean cosmetic result evaluated by the patients was 97.3 (±2.5). Conclusions: In adults, concomitant scheduled surgery is reliable and offers excellent long-term cosmetic results. Moreover,itallowsabetterthoracicexpositionwithnoaddedperioperativerisk.ThemodifiedRavitchtechnique seems more adequate in these patients as it can be used in all types of pectus deformities.