Post-operative Complications of Pectus Excavatum Repair, a Systematic
Review with a New Case Report
Abstract
Objective: We aimed to arouse awareness of the medical staff
and surgeons of possible complications, especially lethal and rare
complications, of pectus excavatum (PE) surgery. Summary
background data: PE is the most common deformity of the chest wall,
characterized by a sternal depression. Patients with PE typically
present with cosmetic concerns due to their abnormal appearance, but
some patients also report exercise intolerance and shortness of breath.
The prevalence and type of life-threatening complications related to the
surgical repair of PE are unknown and underreported. We presented a case
of lethal cardiac event following the PE surgery. We also systematically
reviewed the published case reports. Methods: We described a
case of lethal complication of ventricular-fibrillation and cardiac
arrest following Ravitch procedure for correction of PE in a 10-year-old
boy. We also systematically reviewed relevant cases of PE surgery
complications. Results: From the 506 initial records that was
retrieved from databases search, 95 case reports form 88 articles were
identified over the 23 years. Among them, 79 patients were male, and 17
cases were female. The average age of patients was 18.9 ± 7.7 years
(range: 5-53). Complications had occurred up to 37 years from the time
of surgery, with most of the cases (23%) occurred during the operation.
The most common complications experienced were cardiothoracic
complications and displacement of the implanted steel bar. Complications
resulted in death in eight cases. Conclusion: We recommend that
surgeons should be aware of rare and lethal complications of PE surgery,
particularly for cosmetic indications.