title: Cardiopulmonary response following surgical repair of pectus excavatum in adult patients.
abstract: OBJECTIVE
  Severe pectus excavatum are common in adult patients, often causing psychological complaints and physiological impairments. Although lung function at rest may minimally deteriorate after surgical correction, it remains unclear if surgery improves exercise capacity. The objective of present study is to assess whether the surgical repair of pectus excavatum in adults would improve exercise tolerance.
  
  
  METHODS
  A prospective study was performed to compare pulmonary and cardiovascular function at rest and at maximal exercise, before, and at 1 year after pectus excavatum repair.
  
  
  RESULTS
  From December 2005 to May 2009, 120 adult patients underwent pectus excavatum repair. Of these patients, 70 (nine women, 61 men) underwent thorough preoperative, 6-, and 12-month postoperative assessments, and were included in the present study. Age ranged from 18 to 62 years (mean 27 years). The pectus index (Haller index) was 4.5 ± 1.1. Lung function tests at rest were within the normal range, whereas maximal oxygen uptake (peak VO₂) was only 77 ± 2% of the predicted value. At 1-year follow-up, the pectus excavatum repair was associated with minor changes in lung function tests and significant increase (p=0.0005) in VO₂ (87 ± 2% of the predicted value). Postoperative O₂ pulse increase at maximal exercise suggested that aerobic capacity improvement was the result of better cardiovascular adaptation at maximal workload.
  
  
  CONCLUSIONS
  These results demonstrate sustained improvement in exercise cardiopulmonary function at 1-year follow-up of pectus excavatum surgical repair in adult patients.
authors.affiliation: Service d'explorations fonctionnelles respiratoires EFR Hôpital Calmette CHU Lille, Lille, France. rneviere@univ-lille2.fr
authors.forename: Remi
authors.initials: R
authors.lastname: Neviere
authors.forename: David
authors.initials: D
authors.lastname: Montaigne
authors.forename: Lotfi
authors.initials: L
authors.lastname: Benhamed
authors.forename: Michele
authors.initials: M
authors.lastname: Catto
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Edme
authors.forename: Regis
authors.initials: R
authors.lastname: Matran
authors.forename: Alain
authors.initials: A
authors.lastname: Wurtz
mesh_terms: D000293:Adolescent; D000328:Adult; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005660:Funnel Chest / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011446:Prospective Studies; D012129:Respiratory Function Tests / Q000379:methods; D015656:Respiratory Mechanics / Q000502:physiology; D016896:Treatment Outcome; D055815:Young Adult