title: Cardiac morphologic changes after the Nuss operation for correction of pectus excavatum.
abstract: BACKGROUND
  Pectus excavatum results in compression of the heart and may compromise cardiac function. Several studies have shown that surgical correction improves cardiac function as assessed on echocardiography. However, morphologic changes to support this have not been reported.
  
  
  METHODS
  Between July and December 2011, 109 patients underwent the Nuss operation. We measured the Haller index and other variables. To identify the location of the heart within the chest cavity, the distances from the middle of the spine to the right and left heart walls and from the anterior border of the spine to the anterior and posterior heart walls were measured. To characterize dimensional changes, the anteroposterior, transverse lateral, and right and left oblique longest lengths were measured.
  
  
  RESULTS
  The postoperative Haller index was significantly different from the preoperative one (2.52±0.40 versus 4.50±1.45; p<0.001). The location changes in the anterior, rightward, and leftward directions were 4.97±8.03 mm (p<0.01), 1.66±7.89 mm (p=0.027), and -2.70±11.12 mm (p=0.01), respectively. The dimensional changes in anteroposterior and right oblique lengths were 5.42±6.42 mm and 16.33±7.77 mm (p<0.01), respectively.
  
  
  CONCLUSIONS
  The heart moved positively in the anterior and rightward directions and negatively in the leftward direction, and the anteroposterior and right oblique dimensions were increased after surgical correction. These data suggest that the heart tends to return to a normal position and shape, and that these changes may contribute to improvement in cardiac function.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Incheon St. Mary's Hospital, Incheon, Republic of Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Jeong
authors.affiliation: Department of Thoracic and Cardiovacular Surgery, Seoul St. Mary's Hospital, Seoul, Republic of Korea.
authors.forename: Hyung Joo
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Thoracic and Cardiovacular Surgery, Daejeon St. Mary's Hospital, Daejeon, Republic of Korea. Electronic address: phenix@catholic.ac.kr.
authors.forename: Jongho
authors.initials: J
authors.lastname: Lee
authors.affiliation: College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Jae Kil
authors.initials: JK
authors.lastname: Park
authors.affiliation: College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Keon Hyeon
authors.initials: KH
authors.lastname: Jo
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D008297:Male; D009206:Myocardium / Q000473:pathology*; D019637:Orthopedic Procedures / Q000009:adverse effects*; D055815:Young Adult
keywords: 5