Literature DB >> 16080931

Pectus excavatum in a 112-year autopsy series: anatomic findings and the effect on survival.

Robert E Kelly1, M Louise Lawson, Charles N Paidas, Ralph H Hruban.   

Abstract

BACKGROUND/
PURPOSE: The purpose of this study was to determine the frequency of pectus excavatum and associated conditions in a large autopsy series. It also sought to determine whether there were different survival patterns for pectus excavatum patients than for patients without pectus excavatum.
METHODS: A computer-assisted search of autopsy files maintained by Johns Hopkins University was conducted, dating from 1889 to 2001. Each patient's Autopsy Pathology Information System report was reviewed for diagnosis and comorbid conditions. To determine whether there were differences in survival patterns, we tested whether pectus excavatum patients survived longer than controls, using a standard epidemiological method. Each patient in the autopsy series was compared with the 2 patients entered in the autopsy database chronologically immediately before and the 2 patients immediately after the case. A Kaplan-Meier survival analysis was conducted.
RESULTS: Pectus excavatum was identified at autopsy in 62 of 50,496 cases. Of these 62 patients, 17 were 65 years or older and appeared to have died of causes unrelated to pectus excavatum, the oldest being 91 years. Twenty-one were between the ages of 14 and 65 years and were found to have coexisting conditions or syndromes. Six were between the ages of 1 and 4 years. One of the 6 died in 1947 because of complications from pectus repair. No autopsied patient with pectus excavatum died between the ages of 5 and 14 years. Eighteen were infants younger than 1 year, and all 18 died because of conditions unrelated to pectus excavatum. There were no reported cases of pectus excavatum before 1947, and the severity of deformity could not be determined from the autopsy data. Survival analysis indicated that pectus excavatum patients had a different survival than the controls. Pectus excavatum patients tended to die earlier (P = .0001). However, pectus excavatum patients who survived past the age of 56 years tended to survive longer than their matched controls (P = .0001).
CONCLUSION: Although there were no histological abnormalities noted in the cartilage of the pectus excavatum patient's conditions, pectus excavatum was associated with several connective tissue abnormalities. Analysis is consistent with the theory that this condition can impact survival.

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Year:  2005        PMID: 16080931     DOI: 10.1016/j.jpedsurg.2005.05.010

Source DB:  PubMed          Journal:  J Pediatr Surg        ISSN: 0022-3468            Impact factor:   2.545


  21 in total

Review 1.  Pectus excavatum: history, hypotheses and treatment options.

Authors:  Christoph Brochhausen; Salmai Turial; Felix K P Müller; Volker H Schmitt; Wiltrud Coerdt; Jean-Marie Wihlm; Felix Schier; C James Kirkpatrick
Journal:  Interact Cardiovasc Thorac Surg       Date:  2012-03-05

2.  A familial syndrome of pulmonary nontuberculous mycobacteria infections.

Authors:  Janice M Leung; Cedar Fowler; Caroline Smith; Jennifer Adjemian; Cathleen Frein; Reginald J Claypool; Steven M Holland; Rebecca D Prevots; Kenneth Olivier
Journal:  Am J Respir Crit Care Med       Date:  2013-12-01       Impact factor: 21.405

Review 3.  Surgical repair of pectus excavatum.

Authors:  Hiroshi Iida
Journal:  Gen Thorac Cardiovasc Surg       Date:  2010-02-13

4.  Use of laryngeal mask airway for non-endotracheal intubated anesthesia for patients with pectus excavatum undergoing thoracoscopic Nuss procedure.

Authors:  Xiaojun Du; Songsong Mao; Jianxiu Cui; Jue Ma; Guangyan Zhang; Yong Zheng; Haiyu Zhou; Liang Xie; Dongkun Zhang; Ruiqing Shi; Gang Chen
Journal:  J Thorac Dis       Date:  2016-08       Impact factor: 2.895

5.  [Cine MRI of the thorax in patients with pectus excavatum].

Authors:  K A Herrmann; C Zech; T Strauss; R Hatz; S Schoenberg; M Reiser
Journal:  Radiologe       Date:  2006-04       Impact factor: 0.635

6.  Demographic characteristics of pectus deformities across Turkey.

Authors:  Hakan Işık; Hasan Çaylak; Ersin Sapmaz; Okan Karataş; Kuthan Kavaklı; Merve Şengül İnan; Sedat Gürkök; Alper Gözübüyük; Onur Genç
Journal:  Turk Gogus Kalp Damar Cerrahisi Derg       Date:  2020-04-22       Impact factor: 0.332

7.  Epidural analgesia and abnormal coagulation in patients undergoing minimal invasive repair of pectus excavatum.

Authors:  Ara S Media; Frank V de Paoli; Hans K Pilegaard; Anne-Mette Hvas; Peter Juhl-Olsen; Thomas D Christensen
Journal:  Ann Card Anaesth       Date:  2022 Apr-Jun

Review 8.  Systematic review of surgical treatment techniques for adult and pediatric patients with pectus excavatum.

Authors:  William Rainey Johnson; David Fedor; Sunil Singhal
Journal:  J Cardiothorac Surg       Date:  2014-02-07       Impact factor: 1.637

9.  Correction of secondary deformity after Nuss procedure for pectus excavatum by means of cultured autologous cartilage cell injection.

Authors:  Motoki Tamai; Tomohisa Nagasao; Hiroko Yanaga; Yusuke Hamamoto; Tetsukuni Kogure; Yoshio Tanaka
Journal:  Int J Surg Case Rep       Date:  2015-08-20

10.  Pectus updates and special considerations in Marfan syndrome.

Authors:  Stephanie Fraser; Anne Child; Ian Hunt
Journal:  Pediatr Rep       Date:  2018-01-04
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