Chest wall reconstruction in thoracoabdominal ectopia cordis: using the pedicled osteomuscular latissimus dorsi composite flap.
Ectopia cordis is a rare congenital defect characterized by complete or partial displacement of the heart outside the thoracic cavity. Repair of ectopia cordis can present a reconstructive challenge often requiring a staged approach. Ideally, structural integrity and protection of the heart are restored using autologous tissues capable of growth. In addition, reconstruction of the thorax must proceed without compromise to pulmonary or cardiovascular stability. The following article describes repair of thoracoabdominal ectopia cordis in a patient with pentalogy of Cantrell. Reconstruction of the chest wall was accomplished using a musculoosseus composite flap involving segments of the 9th and 10th ribs and overlying pedicled latissimus dorsi muscle. This is the first report known to the authors of such a repair.
Division of Plastic and Reconstructive Surgery, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA. joshualampert@gmail.com
Joshua A
JA
Lampert
Marco
M
Harmaty
Elizabeth Chabner
EC
Thompson
Suvro
S
Sett
R Michael
RM
Koch
D034861:Abdominal Wall / Q000002:abnormalities / Q000601:surgery; D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000601:surgery; D000792:Angiography / Q000379:methods; D016025:Bone Transplantation / Q000379:methods; D002675:Child, Preschool; D054083:Ectopia Cordis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006554:Hernia, Umbilical / Q000601:surgery; D006801:Humans; D010369:Pectoralis Muscles / Q000601:surgery / Q000637:transplantation*; D011300:Preoperative Care / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D012272:Ribs / Q000601:surgery / Q000637:transplantation*; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply*; D035441:Thoracic Wall / Q000002:abnormalities; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology