Catastrophic cardiac injuries encountered during the minimally invasive repair of pectus excavatum

This paper presents four severe cardiac injuries that occurred in patients who underwent the minimally invasive repair of pectus excavatum (MIRPE). These complications occurred in different clinical settings, namely in a patient with an extremely severe form of pectus, in a patient who had previously undergone an open repair, after a previous open heart surgery, and at the time of bar removal. The purpose of this article is to review the circumstances leading to these cardiac injuries, share what we have learned from these patients, and hopefully help avoid these complications in the future.

Keywords: Pectus excavatum, Complications, Death, NUSS procedure, Reoperative surgery

a Department of Surgery, University of Montreal, Hôpital Sainte-Justine, Montreal, Quebec, Canada

b Departments of Surgery and Pediatrics, Albert Einstein College of Medicine, Schneider Childrens Hospital, New Hyde Park, New York

c The Floating Hospital for Children, Tufts Associate Professor of Surgery, Director of the Kiwanis Pediatric Trauma Institute, Boston, Massachusetts

d Department of Surgery, Columbia University Medical Center, Morgan Stanley Children's Hospital of NY-Presbyterian, New York, New York

Address reprint requests and correspondence: Sarah Bouchard, MD, FRCSC, FACS, Hôpital Sainte-Justine, 3175, Côte-Sainte-Catherine, Montreal, Quebec, H3T 1C5, Canada

PII: S1055-8586(09)00003-1

doi:10.1053/j.sempedsurg.2009.02.002

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