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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 Ottobre;40(5):725-31

THORACIC PAPERS 

 ORIGINAL ARTICLES

Sur­gical cor­rec­tion of ­pectus exca­vatum and car­i­natum

Robicsek F., Fokin A.

From the Depart­ment of Tho­racic and Car­di­o­vas­cular Sur­gery Car­o­linas Med­ical ­Center and The ­Heineman Med­ical ­Research Foun­da­tion Char­lotte, ­North Car­o­lina, USA

The ­author ­presents ­three ­decades of expe­ri­ence in the man­age­ment of ante­rior ­chest ­wall defor­mities. ­During ­this ­period ­more ­than 800 oper­a­tions ­were per­formed on ­patients ­with ­pectus exca­vatum and car­i­natum. In ­this ­series, ­there was no ­death and ­serious com­pli­ca­tions ­were ­rare. The ­author ­believes ­that the prin­ci­ples on ­which sur­gical treat­ment of ­pectus exca­vatum ­should be ­based are as fol­lows: (1) bilat­eral ­removal of the “cul­prit” ­costal car­til­ages, (2) ade­quate mobil­iza­tion of the ­sternum and cor­rec­tion of the ­sternal posi­tional defor­mity by trans­verse oste­otomy, (3) sta­bi­lizing the cor­rected posi­tion of the ­sternum ­with a sub­sternal “ham­mock” sup­port. ­Using ­this tech­nique the ­author devel­oped new sur­gical tech­niques for the cor­rec­tion of dif­ferent varie­ties of ­chest ­wall defor­mities: ­Pectus exca­vatum, asym­metric ­pectus exca­vatum, ­pectus car­i­natum ­with ­xiphoid angu­la­tion, hor­i­zontal ­pectus exca­vatum, asym­metric ­pectus car­i­natum, chon­dros­ternal prom­i­nence ­with chon­dro­glad­i­olar depres­sion, and recur­rent ­pectus exca­vatum. The ­present ­method ­applied for cor­rec­tion of ­pectus exca­vatum uti­lizes the ­above prin­ci­ples and a sub­sternal ­Marlex ­mesh sup­port ­with bilat­eral ­muscle ­coverage. For car­i­natum ­repair, the ­author rou­tinely ­uses posi­tional cor­rec­tion of the ­sternum and ­sternal short­ening. ­Patients who ­have sig­nif­i­cant ­pectus defor­mities ­should ­undergo sur­gical ­repair, pref­er­ably ­between one and ­eight ­years of age.

lingua: Inglese


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