[Indications for the surgical treatment of the funnel chest]

to establish the indications for surgical treatment of the funnel chest.

There was a retrospective and prospective analysis performed of the methods of investigation and treatment of 504 patients operated for the funnel chest during the period of 35 years (1968-2002). In order to make a right diagnosis and to establish the indications for surgical treatment a standard algorithm of investigations was prepared: examination, collecting the detailed life history, establishing a type and a degree of deformation, chest and column radiological examination, ECG, spirography and heart ultrasound examination.

On basis of physical examination and anamnestic data the most clinical signs and complaints were established. The heart compression was found in preoperative X-rays in 476 (94.4%) patients, the heart was rotated and dislocated in 441 (87.5%) patients. Postoperatively 96.1% of patients were free of the heart compression symptoms and for 71.8% the heart rotation has disappeared. The pathological ECG findings were recorded for 382 (71.8%) patients and abnormal spirograms were taken for 31 (8.5%) patients.

The following indications for the funnel chest surgical treatment were established: - obvious funnel chest diagnozed by physical examination, - complaints and disturbances clear from anamnestic data, - heart rotation and compression established by radiological examination, - pathological findings in cardiorespiratory system (ECG, echocardiography, and spirography). An optimal age for operation was found out to be between 3 and 7 years.