Does the Nuss procedure for treating pectus excavatum compromise the long term internal mammary artery flow? A systematic review

2021 ◽  
Author(s):  
Hany H. Elsayed ◽  
Taha A. Ahmed ◽  
Aly S. Hassaballa ◽  
Hazem Y. Sharkawy
Keyword(s):  
Systematic Review ◽  
Pectus Excavatum ◽  
Internal Mammary Artery ◽  
Nuss Procedure ◽  
Internal Mammary ◽  
Artery Flow

scholarly journals Internal Mammary Artery Compression After Pectus Excavatum Repair Does Not Increase Risk of Hemorrhagic Complications in Pediatric Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Tamás Kovács ◽  
Gyula Pásztor ◽  
Anna Rieth
Keyword(s):  
Pectus Excavatum ◽  
Internal Mammary Artery ◽  
Study Data ◽  
Minimal Invasive ◽  
Nuss Procedure ◽  
Vascular Changes ◽  
Mammary Arteries ◽  
Hemorrhagic Complications ◽  
Increase Risk ◽  
Internal Mammary

Objectives: Minimal invasive repair of pectus excavatum (MIRPE) described by Nuss is the most popular correction nowadays of this deformity. During the introduction of the bars, they can hurt or compress the internal mammary arteries (IMA). The aim of this study was to observe the prevalence of IMA compression in children after MIRPE. Also, we examined if IMA obstruction increases the risk of complications at bar removal, and if these vascular changes are reversible.Materials and Methods: All patients operated on pectus excavatum in our tertiary pediatric surgical center between 2013 and 2019 were involved in the study. Data of age, sex, number of bars and characteristics of the deformity were examined. IMA flow was checked by Doppler ultrasound (DUS) after MIRPE and after bar removal, too.Results: Among 41 patients with mean age of 15.2 years there were 18 asymmetrical deformities, 23 sternal rotations. Mean pectus index was 4.01. After the Nuss procedure 7(9%) stenoses and 10(12%) occlusions of IMA were found on DUS. After bar removal 3 of 4 stenoses have resolved, but all examined occlusions (3/3) persisted. There were no complications during bar removals.Conclusion: IMA compression after MIRPE in children is uncommon, and is not influenced by severity of deformity. Obstruction of these vessels does not increase the risk of hemorrhagic complications at bar removal. Data of larger cohort are needed to determine reversibility of these changes.

Multivessel Coronary Revascularization Without Saphenous Vein: Long-term Results of Bilateral Internal Mammary Artery Grafting

1983 ◽  
Vol 36 (5) ◽  
pp. 540-547 ◽  
Author(s):  
Bruce W. Lytle ◽  
Delos M. Cosgrove ◽  
Gary L. Saltus ◽  
Paul C. Taylor ◽  
Floyd D. Loop
Keyword(s):  
Saphenous Vein ◽  
Internal Mammary Artery ◽  
Coronary Revascularization ◽  
Long Term Results ◽  
Internal Mammary

Abstract 2992: Percutaneous Coronary Intervention With Drug Eluting Stents Versus Left Internal Mammary Artery Grafting For Patients With Isolated Lesion In The Proximal Segment Of Left Anterior Desceding Coronary Artery, Suffering From Chronic Stable Angina.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sophia Vaina ◽  
Konstantinos Toutouzas ◽  
Chrysoula Patsa ◽  
Eleftherios Tsiamis ◽  
Elli Stefanadi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Stable Angina ◽  
Internal Mammary Artery ◽  
Left Internal Mammary Artery ◽  
Chronic Stable Angina ◽  
Long Term Results ◽  
Internal Mammary ◽  
Drug Eluting ◽  
Surgical Group

Introduction: Coronary artery bypass grafting (CABG) with left internal mammary artery (LIMA) and percutaneous transluminal coronary angioplasty (PCI) with drug eluting stent (DES) implantation are both effective to treat ischemic heart disease. In the current study we evaluated the long term results of the two methods in patients (pts) with isolated proximal left anterior descending artery lesion (pLAD), suffering from chronic stable angina (CSA). Methods: We included 280 pts, 170 with DES implantation and 110 with LIMA grafting. Primary end points were the occurrence of major adverse cardiac events (MACE), defined as: Death, myocardial infarction and target vessel revascularization (TVR). Secondary end-points included the length of hospitalization, in-hospital complications and the recurrence of chest pain. Pts were followed-up clinically. Results: Mean follow-up period was two years (midrange, one to three years). MACE was 5.29% in the DES group and 2.72% in the surgical group (p=0.37). TVR was 3.52% after PCI and 0% after CABG (p=0.08). The event-free survival curve was similar between the two groups (Figure ). More in-hospital complications were observed in the surgical group compared with the PCI group (16.36% vs. 1.17%, respectively, p=0.01). Recurrent angina was 4.11% in the DES group and 6.36% in CABG group (p = 0.41). Conclusions : In the current study the two procedures had similar long-term results, even though the surgical approach was associated with increased in-hospital complications and longer hospitalization. Therefore, both revascularization modalities can be used to treat pLAD lesions in pts with CSA.

scholarly journals Long-term (5 to 12 years) serial studies of internal mammary artery and saphenous vein coronary bypass grafts

1985 ◽  
Vol 89 (2) ◽  
pp. 248-258 ◽  
Author(s):  
Bruce W. Lytle ◽  
Floyd D. Loop ◽  
Delos M. Cosgrove ◽  
Norman B. Ratliff ◽  
K!rk Easley ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Internal Mammary Artery ◽  
Coronary Bypass ◽  
Bypass Grafts ◽  
Coronary Bypass Grafts ◽  
Internal Mammary
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