Evaluation of the internal thoracic artery blood flow before and after Nuss operation: is it reversible?

Yıl 2017, Cilt: 30 Sayı: 1, 24 - 29, 15.01.2017

Pınar Kuru-bektaşoğlu Nezih Onur Ermerak Canan Cimşit Çağatay Çetinkaya Hıncal Özbakır Nural Bekiroğlu Tunç Laçin Mustafa Yüksel

https://doi.org/10.5472/marumj.299383

Cited By: 1

Öz

Objective: Obstruction of the internal thoracic arteries (ITAs) by

the Nuss bars in minimally invasive repair of pectus excavatum

(MIRPE) has been documented in the literature. In this study, we

aim to investigate the patency of ITAs before and after repair of the

pectus excavatum with the Nuss procedure, by using color Doppler

ultrasonography (US).

Materials and Methods: Nineteen patients who underwent

Nuss procedure were included in this study prospectively. Color

Doppler US examinations were performed for comparing ITA

patency after insertion of the Nuss bars and after their removal.

Patients were evaluated according to gender, age, symmetry of

deformity, Haller index, and the number of Nuss bars inserted.

Results: Nineteen patients operated with MIRPE (17 male and

2 females with a mean age 21.78±6.35) were enrolled in the study.

Eight patients (42.1%) with normal ITA blood flow preoperatively

had normal blood flow after removal of the bar. In preoperative

examination, 6 patients had bilateral (n=2) or unilateral (n=4)

obstruction of the ITA and 5 patients had bilateral (n=2) or

unilateral (n=3) abnormally disturbed flow. After the bar removal

only 2 (10%) of the affected patients (57.9 %) still had obstruction

whereas patent blood flow of the ITAs has been noted in 9 patients.

Conclusion: We have shown that after the Nuss bar removal,

only 10% of the ITAs are compromised

Anahtar Kelimeler

Pectus excavatum, Chest wall deformities, Internal thoracic arteries, Minimally invasive repair of pectus excavatum, Doppler ultrasonography

Kaynakça

• Kelly RE Jr. Pectus excavatum: historical background,
• clinical picture, preoperative evaluation and criteria for
• operation. Semin Pediatr Surg 2008;17:181-93. doi:
• 10.1053/j.sempedsurg.2008.03.002.