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Case Reports
. 2023 Jun 2;1(3):454-457.
doi: 10.1016/j.atssr.2023.05.005. eCollection 2023 Sep.

Intraoperative Hemodynamic Instability in Concomitant Pectus Excavatum and Scoliosis

Gregory Keefe  1 , Eduardo C Beauchamp  2   3 , James D Lilly  4 , Vincent P Duron  1 , Richard C E Anderson  5 , Michael G Vitale  6 , Jeffrey L Zitsman  1
Affiliations
Case Reports

Intraoperative Hemodynamic Instability in Concomitant Pectus Excavatum and Scoliosis

Gregory Keefe et al. Ann Thorac Surg Short Rep. .

Abstract

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.

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Figures

Figure 1
Figure 1
Pictures demonstrating patient’s pectus excavatum.
Figure 2
Figure 2
Computed tomography with (A) sagittal and (B) axial views of the chest. The distance between the xiphoid process and the T10 vertebral body is 1.3 cm (A). A collapsed inferior vena cava is outlined (dotted lines).
Figure 3
Figure 3
Computed tomography of the chest (A) before and (B) after pectus repair. The Haller index improved from 19.2 to 4.7. The dotted lines encircle the inferior vena cava.
See this image and copyright information in PMC

References

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