Nuss procedure in the adult population for correction of pectus excavatum

Cristine S. Velazco, Reza Arsanjani, Dawn E. Jaroszewski

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Minimally invasive repair of pectus excavatum has been successfully modified for use in adult patients. Many patients present in adulthood with progression of symptoms as the chest wall becomes less compliant with age. A thorough workup is completed including echocardiogram and chest CT to evaluate for anatomic abnormalities. Cardiopulmonary exercise testing is done to quantify the physiologic impact. Modifications of the original Nuss procedure required to allow for successful adult repair include the use of forced sternal elevation, the use of multiple bars, medial bar fixation, and interspace support to prevent bar rotation and migration. Occasionally, fractures may occur that require an open procedure and osteotomy or cartilage resection and hybrid approach incorporating the principals of intrathoracic support and osteotomy with bar stabilization.

Original languageEnglish (US)
JournalSeminars in Pediatric Surgery
DOIs
StateAccepted/In press - Jan 1 2018

Keywords

  • Adults
  • MIPRE
  • Modified Nuss procedure
  • Pectus excavatum
  • Sternal elevation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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