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Vascular thoracic outlet syndrome developed after minimally invasive repair of pectus excavatum

Vascular thoracic outlet syndrome developed after minimally invasive repair of pectus excavatum The Nuss procedure is a minimally invasive surgical repair technique for pectus excavatum with fewer delayed complications compared to open procedures. We report the case of a 22-year-old man with deep pectus excavatum who developed vascular thoracic outlet syndrome after the Nuss procedure. Further evaluation demonstrated that the first rib was causing severe obstruction of the right subclavian artery. The patient showed clinical features of subclavian artery compression. A first rib resection, division of the anterior scalene muscle and fibrous bands provided complete relief of the complaints. The forced structural and spatial changes produced by the elevation of the depressed upper chest might have caused this complication. Vascular thoracic outlet syndrome should be kept in mind as a possible complication in patients who have undergone minimally invasive repair of pectus excavatum, and this complication can be treated by first rib resection. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cardio-Thoracic Surgery Oxford University Press

Vascular thoracic outlet syndrome developed after minimally invasive repair of pectus excavatum

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References (5)

Publisher
Oxford University Press
Copyright
The Author 2013. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Subject
CASE REPORTS
ISSN
1010-7940
eISSN
1873-734X
DOI
10.1093/ejcts/ezt163
pmid
23525153
Publisher site
See Article on Publisher Site

Abstract

The Nuss procedure is a minimally invasive surgical repair technique for pectus excavatum with fewer delayed complications compared to open procedures. We report the case of a 22-year-old man with deep pectus excavatum who developed vascular thoracic outlet syndrome after the Nuss procedure. Further evaluation demonstrated that the first rib was causing severe obstruction of the right subclavian artery. The patient showed clinical features of subclavian artery compression. A first rib resection, division of the anterior scalene muscle and fibrous bands provided complete relief of the complaints. The forced structural and spatial changes produced by the elevation of the depressed upper chest might have caused this complication. Vascular thoracic outlet syndrome should be kept in mind as a possible complication in patients who have undergone minimally invasive repair of pectus excavatum, and this complication can be treated by first rib resection.

Journal

European Journal of Cardio-Thoracic SurgeryOxford University Press

Published: Sep 22, 2013

Keywords: Pectus excavatum Nuss procedure Thoracic outlet syndrome Vascular compression First rib resection Complication

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