title: Pectus excavatum and cardiac surgery: simultaneous correction advocated.
abstract: BACKGROUND
  Severe pectus excavatum may be present in combination with cardiac conditions requiring open-heart surgery. The best strategy for this situation has been debated controversially.
  
  
  METHODS
  In a retrospective study, we analyzed all our patients undergoing concurrent pectus excavatum correction and open-heart surgery.
  
  
  RESULTS
  Ten patients aged 9 to 70 years underwent a simultaneous combined surgical procedure between 2001 and 2013. Indications for cardiac surgery were various forms of congenital and acquired heart disease including coronary artery disease with internal thoracic artery grafts and ascending aortic aneurysms. A modified Ravitch procedure was performed for pectus excavatum correction (mean Haller-Index 5.0). Mean operating time was 364 (210-495) minutes and mean duration of cardiopulmonary bypass was 125 (54-222) minutes. All procedures were completed successfully. Postoperatively minor complications were observed in three patients. In-hospital and 30-day mortalities were nil. Good cosmetic and functional results were achieved in all patients.
  
  
  CONCLUSIONS
  Our data demonstrate that simultaneous pectus excavatum correction and cardiac surgery is effective and reliable. A combined approach is advocated if candidates for cardiac surgery present with significant pectus excavatum deformity.
authors: Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany.
authors: Joachim
authors: J
authors: Schmidt
authors: Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany.
authors: Bassam
authors: B
authors: Redwan
authors: Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany.
authors: Volkan
authors: V
authors: Koesek
authors: Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany.
authors: Hermann
authors: H
authors: Aebert
authors: Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany.
authors: Tonny Djie-Tiong
authors: TD
authors: Tjan
authors: Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany.
authors: Sven
authors: S
authors: Martens
authors: Department of Cardiothoracic Surgery, University Hospital of Muenster, Muenster, Germany.
authors: Karsten
authors: K
authors: Wiebe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002315:Cardiopulmonary Bypass; D002648:Child; D005240:Feasibility Studies; D005260:Female; D005660:Funnel Chest / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome