title: Intrapericardial migration of dislodged sternal struts as late complication of open pectus excavatum repairs.
abstract: We present a case of sternal steel strut dislodgement and migration in a patient undergoing Ravitch repair for pectus excavatum (PE) 37 years ago. Broken struts perforated the right ventricle and right ventricular outflow tract (RVOT) and additionally migrated into the left upper lobar bronchus.Dislodged sternal struts represent rare complications after surgical repair of patients suffering from pectus excavatum. Reviewing the literature, only five cases of intrapericardial migration of dislodged sternal struts or wires have been reported so far.In our case, the first strut was removed from the airways through a left antero-lateral thoracotomy. Using cardiopulmonary bypass, a second strut was removed via ventriculotomy. These life-threatening sequelae underscore the importance of postoperative follow-up and early removal of osteosynthetic materials used in open PE repair. Accurate preoperative localization of migrated materials and availability of CPB support are crucial for successful surgical removal.
  
  
  BACKGROUND
  The migration of dislodged sternal steel struts or wires into the pericardium and cardiac cavities is a rare but life-threatening complication of open pectus excavatum (PE) repair 1. Removal of these materials poses a challenge for cardiothoracic surgeons. Herein, the authors report a case of migration of dislodged steel struts through the right ventricle and right ventricular outflow tract (RVOT) into the left upper lobar bronchus in a patient who underwent Ravitch repair 37 years ago.
authors: Hannover Medical School, Carl-Neuberg-Str, 1, 30625 Hannover, Germany. Zhang.Ruoyu@mh-hannover.de
authors: Ruoyu
authors: R
authors: Zhang
authors: Christian
authors: C
authors: Hagl
authors: Dmitry
authors: D
authors: Bobylev
authors: Thomas
authors: T
authors: Breymann
authors: Jan D
authors: JD
authors: Schmitto
authors: Axel
authors: A
authors: Haverich
authors: Marcus
authors: M
authors: Krüger
mesh_terms: D020878:Device Removal / Q000379:methods; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000000981:diagnostic imaging / Q000293:injuries*; D011183:Postoperative Complications; D019736:Prostheses and Implants; D013249:Sternum / Q000601:surgery*; D013908:Thoracotomy / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed