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1608 The Role of Transthoracic Ultrasounds to Assess Patients with Pectus Excavatum
  1. N Zampieri,
  2. F Laconi,
  3. G Scire,
  4. A Mantovani,
  5. F Camoglio
  1. Department of Surgical Sciences, Pediatric Surgical Unit, University of Verona, Policlincio G.B. Rossi, Verona, Italy

Abstract

Introduction Pectus excavatum is the most common congenital malformation of the anterior chest wall; the purpose of this study is to assess the role of thoracic ultrasounds in the preoperative workup of patients affected by pectus excavatum.

Materials and Methods An observational study was carried out ibetween january and september 2011. patients aged between 4 and 14 years of age were divided into 4 study groups. group a: healthy patients without pectus excavatum; group b: healthy patients with different grades of untreated pectus excavatum; group c: patients with pectus excavatum treated with nuss bar; group d: patients surgically treated with removed bar.

Results Patients with deeper anatomical depression showed a differential value between inspiration and expiration lower than healthy patients or patients with shallower depression (p<0.05) in any age range considered; a depression deeper than 2.8 cm was associated with lower elasticity of the chest wall; chest dynamicity of patients treated with open techniques showed almost immobility of the parasternal region, with a differential value close to zero, and a differential value inferior to 0.5 cm at the level of the anterior axillary line.

Conclusions Study results confirm that the use of ultrasounds should be introduced as a standard preliminary test. patients with pectus excavatum have altered chest dynamicity if compared to healthy patients.

The study also confirms that the most suitable area of the chest for bar insertion in terms of dynamicity is between the fourth and sixth intercostal space: not necessarily near the deepest point of depression.

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