J Kowalewski1, S Barcikowski, M Brocki. 1. First Department of General Surgery, The Military Medical Academy, Lodz, Poland. wam1klch@polbox.com
Abstract
OBJECTIVE: The study was undertaken in order to assess the degree of impairment of the cardiovascular system in patients with funnel chest and to investigate any changes caused by surgical correction. METHODS: Echocardiographic examinations with systolic, diastolic and ejection volume indices calculation as well as pulmonary function tests were performed 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 function was found to be restricted preoperatively in 18 patients. Inspiratory vital capacity and forced expiratory volume were increased or did not change at follow-up (5 years) in these patients. In cases with normal or moderately restricted pulmonary function (inspiratory vital capacity, forced expiratory volume more than 75% predicted) the reduction of lung function was noted after surgery. Marked haemodynamic improvement was found with the increase of diastolic and ejection volume of both heart ventricles (mainly right one). The improvement was more evident in patients with severe deformations. CONCLUSION: Only in case of severe reduction of lung function in a patient with funnel chest can one expect improvement after surgery. Sternocostal elevation improves function of both heart ventricles at rest.
OBJECTIVE: The study was undertaken in order to assess the degree of impairment of the cardiovascular system in patients with funnel chest and to investigate any changes caused by surgical correction. METHODS: Echocardiographic examinations with systolic, diastolic and ejection volume indices calculation as well as pulmonary function tests were performed 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 function was found to be restricted preoperatively in 18 patients. Inspiratory vital capacity and forced expiratory volume were increased or did not change at follow-up (5 years) in these patients. In cases with normal or moderately restricted pulmonary function (inspiratory vital capacity, forced expiratory volume more than 75% predicted) the reduction of lung function was noted after surgery. Marked haemodynamic improvement was found with the increase of diastolic and ejection volume of both heart ventricles (mainly right one). The improvement was more evident in patients with severe deformations. CONCLUSION: Only in case of severe reduction of lung function in a patient with funnel chest can one expect improvement after surgery. Sternocostal elevation improves function of both heart ventricles at rest.