CARDIORESPIRATORY FUNCTION BEFORE AND AFTER OPERATION FOR PECTUS EXCAVATUM - MEDIUM-TERM RESULTS

Objective: The study was undertaken in order to assess the degree of i mpairment of the cardiovascular system in patients with funnel chest a nd to investigate any changes caused by surgical correction. Methods: Echocardiographic examinations with systolic, diastolic and ejection v olume indices calculation as well as pulmonary function tests were per formed before surgery and at medium-term follow-up on 34 patients who were operated on for pectus excavatum between 1987 and 1992. Results: The mean age was 13.4 years. There were 70.6% males. Pulmonary functio n was found to be restricted preoperatively in 18 patients. Inspirator y vital capacity and forced expiratory volume were increased or did no t change at follow-up (5 years) in these patients. In cases with norma l or moderately restricted pulmonary function (inspiratory vital capac ity, forced expiratory volume more than 75% predicted) the reduction o f lung function was noted after surgery. Marked haemodynamic improveme nt was found with the increase of diastolic and ejection volume of bot h heart ventricles (mainly right one).The improvement was more evident in patients with severe deformations. Conclusion: Only in case of sev ere reduction of lung function in a patient with funnel chest can one expect improvement after surgery. Sternocostal elevation improves func tion of both heart ventricles at rest. (C) 1998 Elsevier Science B.V. All rights reserved.