Normalized cardiopulmonary exercise function in patients with pectus excavatum three years after operation

Area of Science:

• Cardiology
• Pulmonology
• Pediatric Surgery

Background:

• Pectus excavatum can limit cardiac function during exercise.
• The Nuss procedure is a surgical correction for pectus excavatum.

Purpose of the Study:

• To evaluate the impact of the Nuss procedure on cardiopulmonary exercise function in teenagers with pectus excavatum.
• To compare exercise function in patients with controls before and after surgery.

Main Methods:

• Seventy-five teenagers (49 patients, 26 controls) underwent assessment at rest and during exercise.
• Measurements included echocardiography, spirometry, cardiac output, heart rate, and aerobic exercise capacity.
• Assessments were performed preoperatively, and at 1 and 3 years post-Nuss procedure (after bar removal).

Main Results:

• Patients with pectus excavatum had lower maximum cardiac index and forced expiratory volume in the first second (FEV1) preoperatively compared to controls.
• Postoperatively, maximum cardiac index significantly increased, normalizing by 3 years.
• FEV1 also normalized by 1 year postoperatively, with no difference between groups at 3 years.
• Maximum oxygen consumption remained unchanged, and left ventricular dimensions increased similarly in both groups over time.

Conclusions:

• The Nuss procedure improves cardiac index and FEV1 in patients with pectus excavatum.
• Cardiopulmonary function during exercise normalizes three years after the Nuss procedure and bar removal.
• The study highlights the long-term benefits of the Nuss procedure on exercise capacity and respiratory function.