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[Inferior vena cava compression in children with pectus excavatum]

M Dore Reyes1, M Bret Zurita2, P Triana Junco1

  • 1Servicio de Cirugía Pediátrica. Hospital Universitario La Paz. Madrid.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
|May 7, 2019
PubMed

Insights

Severe pectus excavatum (PE) in males can compress the inferior vena cava (IVC), affecting cardiac function. This study found significant IVC diameter changes in PE patients, correlating with deformity severity.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Radiology

Background:

  • Severe pectus excavatum (PE) can cause cardiac chamber distortion.
  • The impact of PE on the inferior vena cava (IVC) is not fully understood.

Purpose of the Study:

  • To investigate if sternal depression in severe PE leads to significant IVC compression.
  • To assess the relationship between PE severity and IVC diameter.

Main Methods:

  • Retrospective analysis of 81 patients (28 PE, 53 controls) between 2015-2017.
  • Cardiac MRI was used to measure suprahepatic IVC diameters (antero-posterior and transverse).
  • Results were compared between groups, adjusting for age and sex.

Main Results:

  • Patients with severe PE exhibited significantly smaller IVC diameters compared to controls.
  • Adjusted analysis revealed statistically significant differences in antero-posterior IVC diameter, particularly in males.
  • A positive correlation was observed between the Haller index (PE severity) and IVC diameter changes.

Conclusions:

  • Male patients with severe PE demonstrate IVC diameter alterations suggestive of compression.
  • These findings correlate with the severity of the pectus excavatum deformity.
  • IVC compression may contribute to clinical symptoms and cardiac dysfunction in severe PE patients.
Abstract

Keywords:
ChildrenInferior vena cava compressionMRIPectus excavatum

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