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Life-threatening hemorrhage during removal of a Nuss bar associated with sternal erosion
David M Notrica1, Lisa E McMahon1, Kevin N Johnson2
1Department of Surgery, Phoenix Children's Hospital, Phoenix, Arizona; University of Arizona College of Medicine Phoenix, Phoenix, Arizona; Department of Surgery, Mayo Clinic Arizona, Phoenix, Arizona.
Abstract:
We present a case of life-threatening hemorrhage occurring during Nuss bar removal without obvious cardiac or major vascular injury. A 19-year-old woman with marfanoid features had undergone a Nuss procedure 3 years earlier for a pectus index of 7.2. A lateral chest radiograph revealed erosion of the upper bar into the sternum. During surgery, a 3.5-L blood loss occurred after removal of the eroded bar. This case provided many opportunities to improve preparedness for bar removal.
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