SIMULTANEOUS REPAIR OF PECTUS EXCAVATUM AND CONGENITAL HEART-DISEASE

Most repair of heart lesions and pectus deformity has been performed i n adult patients using long incisions, sternal splits, excision of def ormed cartilages, and sternal turnover operations that could result in poor cosmesis and chest growth in children because of sternal devascu larization. We performed simultaneous pectus repair and atrial septal defect closure in 2 children using a short longitudinal incision and a voiding a transverse or longitudinal sternal split. After extrapericho ndrial excision of the deformed cartilages and mobilization of the ste rnum from the neurovascular bundles, a transverse wedge of sternum was removed at the level of the third cartilages, allowing cephalad retra ction of the sternum and providing excellent exposure for the intracar diac operation. The cosmetic appearance remains excellent in both pati ents at 1 and 4 years postoperatively. (C) 1997 by The Society of Thor acic Surgeons.