Intraoperative Hemodynamic Instability in Concomitant Pectus Excavatum and Scoliosis

Patients with pectus excavatum and scoliosis can present a unique clinical challenge to operative correction. In patients with severe deformities, vascular structures in between the spine and sternum are at risk of compression, leading to hemodynamic collapse during correction of a spine deformity in the setting of unrepaired pectus excavatum. Careful consideration and multidisciplinary coordination should be used to determine the optimal timing, sequence, and operative approach in repair of the anterior and posterior deformities.