Abstract
Objective: We aimed to retrospectively evaluate the clinical, demographic, clinical and echocardiographic findings of children diagnosed with chest deformity in the pediatric cardiology clinic.
Material and Method: This study enrolled children under the age of 18 years who were referred with chest deformity to our pediatric cardiology unit, over a period of six years (January 2017-December 2022).
Results: The mean age of the patients was 9.9 ± 5.2 years, median 11 years (0-18 years old). 89 patients with abnormal echocardiographic findings: 42 (9.56%) mitral valve prolapse, 18 (4.1%) atrial septal defect, 9 (2%) ventricular septal defect, 8 (1.82%) bicuspid without aortic valve stenosis aortic valve, 5 (1.1%) patent ductus arteriosus, 2 (0.45%) pulmonary stenosis, 2 (0.45%) great artery transposition, 2 (0.45%) hypertrophic cardiomyopathy, subaortic ridge 1 (% 0.27). Cardiac compression was present in 13.4% of the cases with pectus excavatum. 13(%3) patients were operated by a thoracic surgeon. Marfan Syndrome was diagnosed in 7 patients and Noonan Syndrome was diagnosed in 2 patients who applied to our clinic with chest deformity.
Conclusion: We suggest that echocardiographic examination in patients with chest deformity is important in the diagnosis of congenital heart diseases, early diagnosis and treatment of heart compression finding.
Keywords
References
- 1-Yavuzer Ş. Konjenital Anterior Chest Wall Deformities, Turkish Thoracic Society, Thor Surg Bullet September.2011: 164-168. 2- Langer E. Zuckerkandel. Untersuchungen über den mißbildeten Brustkorb des. Herrn JW Wiener med Zeit. 1880; 49: 515.
- 3- Kelly RE, Goretsky MJ, Obermeyer R, Kuhn MA, Redlinger R, Haney TS et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the nuss procedure in 1215 patients. Ann Surg 2010; 252: 107
- 4- Williams AM, Crabbe DC. Pectus deformities of the anterior chest wall. Paediatr Respir Rev 2003;4:237-42.
- 5- Soysal O, Yakıncı C, Durmaz Y. The prevalence of chest wall deformities and an overview of chest wall deformities in primary school children in Malatya city center. Clinic Scien & Doct 1999;5:382-5.
- 6- Robert C. Shamberger. Chest Wall Deformities. In Shilds TW. LoCicero III Reed CA. Feins RH eds. Gen Thor Surg 7th edition. Lippincott Williams & WilkinsCh 43, 2009; 599-628.
- 7- Fonkalsrud EW. Surgical Management of Pectus Carinatum. Oper Techn in Thor and Card Surg 2000; 5: 110-7. 8- Blanco FC, Elliott ST, Sandler AD. Management of congenital chest wall deformities. Semin Plast Surg 2011; 25: 107- 16. 9- Robert C. Shamberger. Chest Wall Deformities. In Shilds TW. LoCicero III Reed CA. Feins RH eds. Gen Thor Surg 7th edition. Lippincott Williams & WilkinsCh 43, 2009; 599-628.
- 10. Van der Bom T, Zomer AC, Zwinderman AH, Meijboom FJ, Bouma BJ, Mulder BJ. The changing epidemiology of congenital heart disease. Nat Rev Cardiol. 2011; 8:50–60.
- 11- ParkJM, Varma SK. Pectus excavatum in children: Diagnostic significance for mitral valve prolapse. The Indian J Pediatr 1990;57 219-22.
- 12- Coln E, Carrasco J, Coln D. Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum. J Pediatr Surg 2006;41: 683–6.
- 13- Simsek Z, Gunay E, Aksakal E, Kutucularoglu MG, Guneren G. Evaluation of cardiopulmonary findings in young adult patients with isolated pectus excavatum. Anat J Card 2011; 1:77-8.
- 14- Akcalı Y, Ceyran H, Hasdiraz L. Chest Wall deformities. Acta Chir Hung 199;38:1-3.
- 15- Sanchez Cascos A. Association of cardiac and sternal malformations. An Esp Pediatr 1989;30:686-95. 16- Kikuchi S, Ingu A, Ito M. Simultaneous repair of pectus excavatum and tetralogy of fallot: report of a case. Ann Thorac Cardiovasc Surg 2005; 11:320-3.
- 17- Zhao L, Feinberg MS, Gaides M, et al. Why is exercise capacity reduced in subjects with pectus excavatum? J Pediatr 2000;136(2):163–7.
- 18- Cahill JL, Lees GM, Robertson HT. A summary of preoperative and postoperative cardiorespiratory performance in patients undergoing pectus excavatum and carinatum repair. J Pediatr Surg 1984;19(4):430–3.
- 19- Kowalewski J, Brocki M, Dryjanski T, et al. Pectus excavatum: increase of right ventricular systolic, diastolic, and stroke volumes after surgical repair. J Thorac Cardiovasc Surg 1999;118(1):87–92.
- 20- Cobben JM, Oostra RJ, van Dijk FS. Pectus excavatum and carinatum. Eur J Med Genet 2014; 57: 414-417.
- 21- Andreescu N, Sharma A, Mihailescu A et al. Chest wall deformities and their possible associations with different genetic syndromes. Europ Rev for Med and Pharmacol Scien. 2022; 26: 5107-5114.
- 22- Randhawa AK, Mishra C, Gogineni SB, Shetty S. Marfan syndrome: report of two cases with review of literature. Niger J Clin Pract 2012; 15:364-8.
- 23- Hickey EJ, Mehta R, Elmi M, Asoh K, McCrindle BW, Williams WG, Manlhiot C, Benson L. Survival implications: hypertrophic cardiomyopathy in Noonan syndrome. Congenit Heart Dis. 2011;6:41–7.
Abstract
Amaç: Çocuk kardiyoloji kliniğinde göğüs deformitesi tanısı alan çocukların klinik, demografik, klinik ve ekokardiyografik bulgularını retrospektif olarak değerlendirmeyi amaçladık.
Gereç Ve Yöntem: Bu çalışmaya altı yıl boyunca (Ocak 2017-Aralık 2022) pediatrik kardiyoloji birimimize göğüs deformitesi ile başvuran 18 yaş altı çocuklar dahil edildi.
Bulgular: Hastaların yaş ortalaması 9,9 ± 5,2 median:11 yaş (0-18 yaş) idi. Anormal ekokardiyografik bulguları olan 89 hasta: 42 (%9,56) mitral kapak prolapsusu, 18 (%4,1) atriyal septal defekt, 9 (%2) ventriküler septal defekt, 8 (%1,82) aort kapak darlığı olmayan biküspid aort kapak, 5 (%1,1) patent duktus arteriozus, 2 (%0,45) pulmoner darlık, 2 (%0,45) büyük arter transpozisyonu, 2 (%0,45) hipertrofik kardiyomiyopati, subaortik ridge 1 (%0,27) idi. Pektus ekskavatumlu olguların %13.4'ünde kardiyak bası vardı. 13(%3) hasta göğüs cerrahisi tarafından opere edildi. Göğüs deformitesi ile kliniğimize başvuran 7 hastada Marfan Sendromu, 2 hastada Noonan Sendromu teşhis edildi.
Sonuç: Göğüs deformitesi olan hastalarda ekokardiyografik incelemenin doğumsal kalp hastalıklarının tanısında, kalp sıkışması bulgusunun erken tanı ve tedavisinde önemli olduğunu düşünüyoruz.
Keywords
References
- 1-Yavuzer Ş. Konjenital Anterior Chest Wall Deformities, Turkish Thoracic Society, Thor Surg Bullet September.2011: 164-168. 2- Langer E. Zuckerkandel. Untersuchungen über den mißbildeten Brustkorb des. Herrn JW Wiener med Zeit. 1880; 49: 515.
- 3- Kelly RE, Goretsky MJ, Obermeyer R, Kuhn MA, Redlinger R, Haney TS et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the nuss procedure in 1215 patients. Ann Surg 2010; 252: 107
- 4- Williams AM, Crabbe DC. Pectus deformities of the anterior chest wall. Paediatr Respir Rev 2003;4:237-42.
- 5- Soysal O, Yakıncı C, Durmaz Y. The prevalence of chest wall deformities and an overview of chest wall deformities in primary school children in Malatya city center. Clinic Scien & Doct 1999;5:382-5.
- 6- Robert C. Shamberger. Chest Wall Deformities. In Shilds TW. LoCicero III Reed CA. Feins RH eds. Gen Thor Surg 7th edition. Lippincott Williams & WilkinsCh 43, 2009; 599-628.
- 7- Fonkalsrud EW. Surgical Management of Pectus Carinatum. Oper Techn in Thor and Card Surg 2000; 5: 110-7. 8- Blanco FC, Elliott ST, Sandler AD. Management of congenital chest wall deformities. Semin Plast Surg 2011; 25: 107- 16. 9- Robert C. Shamberger. Chest Wall Deformities. In Shilds TW. LoCicero III Reed CA. Feins RH eds. Gen Thor Surg 7th edition. Lippincott Williams & WilkinsCh 43, 2009; 599-628.
- 10. Van der Bom T, Zomer AC, Zwinderman AH, Meijboom FJ, Bouma BJ, Mulder BJ. The changing epidemiology of congenital heart disease. Nat Rev Cardiol. 2011; 8:50–60.
- 11- ParkJM, Varma SK. Pectus excavatum in children: Diagnostic significance for mitral valve prolapse. The Indian J Pediatr 1990;57 219-22.
- 12- Coln E, Carrasco J, Coln D. Demonstrating relief of cardiac compression with the Nuss minimally invasive repair for pectus excavatum. J Pediatr Surg 2006;41: 683–6.
- 13- Simsek Z, Gunay E, Aksakal E, Kutucularoglu MG, Guneren G. Evaluation of cardiopulmonary findings in young adult patients with isolated pectus excavatum. Anat J Card 2011; 1:77-8.
- 14- Akcalı Y, Ceyran H, Hasdiraz L. Chest Wall deformities. Acta Chir Hung 199;38:1-3.
- 15- Sanchez Cascos A. Association of cardiac and sternal malformations. An Esp Pediatr 1989;30:686-95. 16- Kikuchi S, Ingu A, Ito M. Simultaneous repair of pectus excavatum and tetralogy of fallot: report of a case. Ann Thorac Cardiovasc Surg 2005; 11:320-3.
- 17- Zhao L, Feinberg MS, Gaides M, et al. Why is exercise capacity reduced in subjects with pectus excavatum? J Pediatr 2000;136(2):163–7.
- 18- Cahill JL, Lees GM, Robertson HT. A summary of preoperative and postoperative cardiorespiratory performance in patients undergoing pectus excavatum and carinatum repair. J Pediatr Surg 1984;19(4):430–3.
- 19- Kowalewski J, Brocki M, Dryjanski T, et al. Pectus excavatum: increase of right ventricular systolic, diastolic, and stroke volumes after surgical repair. J Thorac Cardiovasc Surg 1999;118(1):87–92.
- 20- Cobben JM, Oostra RJ, van Dijk FS. Pectus excavatum and carinatum. Eur J Med Genet 2014; 57: 414-417.
- 21- Andreescu N, Sharma A, Mihailescu A et al. Chest wall deformities and their possible associations with different genetic syndromes. Europ Rev for Med and Pharmacol Scien. 2022; 26: 5107-5114.
- 22- Randhawa AK, Mishra C, Gogineni SB, Shetty S. Marfan syndrome: report of two cases with review of literature. Niger J Clin Pract 2012; 15:364-8.
- 23- Hickey EJ, Mehta R, Elmi M, Asoh K, McCrindle BW, Williams WG, Manlhiot C, Benson L. Survival implications: hypertrophic cardiomyopathy in Noonan syndrome. Congenit Heart Dis. 2011;6:41–7.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Early Pub Date | January 23, 2023 |
| Publication Date | March 22, 2023 |
| Acceptance Date | March 3, 2023 |
| Published in Issue | Year 2023 Volume: 13 Issue: 2 |
