Indications and guidelines for pectus excavatum repair

Area of Science:

• Thoracic surgery
• Pediatric surgery
• Cardiology

Background:

• The Nuss procedure, introduced in 1997, has significantly increased awareness of pectus excavatum as both an anatomic and functional problem.
• Increased referrals for pectus excavatum repair have facilitated clinical analyses to define physiologic impairments and drive surgical technique improvements.

Purpose of the Study:

• To review the current understanding of pectus excavatum, its physiologic impairments, and the effectiveness of surgical repair techniques.
• To highlight the impact of the Nuss procedure on patient awareness and surgical advancements.

Main Methods:

• Review of clinical assessments, diagnostic imaging, and cardiorespiratory testing in pectus excavatum patients.
• Analysis of outcomes following surgical repair, including the Nuss procedure and open repair.

Main Results:

• Pectus excavatum is associated with significant cardiorespiratory impairments, with defined criteria for surgical repair.
• Evidence supports improved cardiorespiratory function post-repair.
• The Nuss procedure and open repair are reported as safe and effective with technical improvements.

Conclusions:

• Objective evidence confirms cardiorespiratory impairment in severe pectus excavatum.
• Timely work-up and surgical referral are recommended for eligible patients.
• Regular follow-up during pubertal growth is advised.