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D. Nuss, R. Kelly, R. Kelly, D. Croitoru, D. Croitoru, M. Katz, M. Katz (1998)
A 10-year review of a minimally invasive technique for the correction of pectus excavatum.Journal of pediatric surgery, 33 4
Q. Ballouhey, B. Léobon, J. Trinchero, C. Baunin, P. Galinier, J. Gauzy (2012)
Mechanical occlusion of the inferior vena cava: an early complication after repair of pectus excavatum using the Nuss procedure.Journal of pediatric surgery, 47 12
A. Williams, D. Crabbe (2003)
Pectus deformities of the anterior chest wall.Paediatric respiratory reviews, 4 3
A. Hebra, Barbara Swoveland, Michael Egbert, E. Tagge, K. Georgeson, H. Othersen, D. Nuss (2000)
Outcome analysis of minimally invasive repair of pectus excavatum: review of 251 cases.Journal of pediatric surgery, 35 2
Seunghoon Lee, S. Ryu, Seong-Joon Cho (2011)
Thoracic outlet syndrome after the Nuss procedure for the correction of extreme pectus excavatum.The Annals of thoracic surgery, 91 6
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.
European Journal of Cardio-Thoracic Surgery – Oxford University Press
Published: Sep 22, 2013
Keywords: Pectus excavatum Nuss procedure Thoracic outlet syndrome Vascular compression First rib resection Complication
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