Cardiac perforation by a pectus bar after surgical correction of pectus excavatum : case report and review of the literature

• Published in: Pediatric surgery international Vol. 24; no. 5; pp. 617 - 620
• Main Authors: Gips, Hadas, Zaitsev, Konstantin, Hiss, Jehuda
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.05.2008; Springer Nature B.V
• Subjects: Adolescent; Cardiac perforation; Case Report; Death; Fatal Outcome; Funnel Chest - diagnostic imaging; Funnel Chest - surgery; Heart Injuries - diagnosis; Heart Injuries - etiology; Humans; Intraoperative Complications; Male; Medicine; Medicine & Public Health; Nuss procedure; Pectus excavatum; Pediatric Surgery; Pediatrics; Ravitch repair; Rupture; Surgery; Tomography, X-Ray Computed; Wounds, Penetrating - diagnosis; Wounds, Penetrating - etiology; Pectus excavatum; Death; Cardiac perforation; Ravitch repair; Nuss procedure
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-007-2097-1

Pectus excavatum (PE) is a congenital sternal depression. The two most popular methods of correction are the highly modified Ravitch repair (HMRR) and the Nuss procedure. Presented here is a case of PE surgical correction in a 17.5-year-old male, beginning with the Nuss technique and converting to the HMRR during surgery, due to unsatisfying results. The procedure inadvertently culminated in perforation of the heart and lungs by the inserted pectus bar, with aggravation of the damage by resuscitation efforts. This article analyzes the chain of events leading to the patient’s death and reviews the literature on the subject.