Cardiac function assessed by transesophageal echocardiography during pectus excavatum repair.
BACKGROUND
We assessed end-diastolic right ventricular (RV) dimensions and left ventricular (LV) ejection fraction by use of intraoperative transesophageal echocardiography before and after surgical correction of pectus excavatum in adults.


METHODS
A prospective study was conducted including 17 patients undergoing surgical correction of pectus excavatum according to the technique of Ravitch-Shamberger between 1999 and 2004. Intraoperative transesophageal echocardiography was performed under general anesthesia before and after surgery to assess end-diastolic RV dimensions and LV ejection fraction. The end-diastolic RV diameter and area were measured in four-chamber and RV inflow-outflow view, and the RV volume was calculated from these data. The LV was assessed by transgastric short-axis view, and its ejection fraction was calculated by use of the Teichholz formula.


RESULTS
The end-diastolic RV diameter, area, and volume all significantly increased after surgery (mean values +/- SD, respectively: 2.4 +/- 0.8 cm versus 3.0 +/- 0.9 cm, p < 0.001; 12.5 +/- 5.2 cm(2) versus 18.4 +/- 7.5 cm(2), p < 0.001; and 21.7 +/- 11.7 mL versus 40.8 +/- 23 mL, p < 0.001). The LV ejection fraction also significantly increased after surgery (58.4% +/- 15% versus 66.2% +/- 6%, p < 0.001).


CONCLUSIONS
Surgical correction of pectus excavatum according to Ravitch-Shamberger technique results in a significant increase in end-diastolic RV dimensions and a significantly increased LV ejection fraction.
Krueger
Thorsten
T
Thoracic and Vascular Surgery Service, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. thorsten.krueger@chuv.ch
Chassot
Pierre-Guy
PG
Christodoulou
Michel
M
Cheng
Cai
C
Ris
Hans-Beat
HB
Magnusson
Lennart
L
D000293:Adolescent; D000328:Adult; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D005660:Funnel Chest / Q000503:physiopathology / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011446:Prospective Studies; D020127:Recovery of Function; D013318:Stroke Volume; D013908:Thoracotomy / Q000379:methods*; D016277:Ventricular Function, Left / Q000502:physiology*; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult