PMID- 24686153
OWN - NLM
STAT- MEDLINE
DCOM- 20150209
LR  - 20161125
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 19
IP  - 1
DP  - 2014 Jul
TI  - Patency of the internal mammary arteries after removal of the Nuss bar: an 
      initial report.
PG  - 6-9
LID - 10.1093/icvts/ivu083 [doi]
AB  - OBJECTIVES: Surgical correction of pectus excavatum (PE) has shifted to the 
      modern minimally invasive Nuss procedure, which proved to be safe and effective. 
      In order to restore the dented deformity, custom-curved metal bars provide 
      continuous retrosternal pressure but cross the habitat of the internal mammary 
      arteries (IMAs) directly affecting their patency. In this initial report, we 
      sought to assess the patency of the IMAs in the first 6 patients who underwent 
      Nuss bar removal in our department. METHODS: In 2010, we started to perform 
      correction of PE using the Nuss bar technique. In 2013, observational analysis 
      was performed on the first 6 patients who underwent removal of the Nuss bar. 
      Computed tomography angiography (CTA) was performed in order to assess the 
      patency of both IMAs directly after removal. RESULTS: In 4 (67%) patients, IMA 
      patency was affected unilaterally (total obstruction or highly decreased flow 
      pattern) corresponding with the lowest retrosternal side. CONCLUSIONS: According 
      to our preliminary results, the oppressive force of Nuss bars interferes with IMA 
      patency and thereby compromises future usability in coronary artery bypass 
      grafting (CABG). We recommend that patients undergoing CABG following the Nuss 
      procedure undergo preoperative evaluation of IMA patency. This study will be 
      continued to include a larger number of patients including follow-up CTA one year 
      after removal of the bar.
CI  - (c) The Author 2014. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Kulcu, Kemal
AU  - Kulcu K
AD  - Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands.
FAU - Elenbaas, Ted W
AU  - Elenbaas TW
AD  - Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands.
FAU - Nguyen, Duy Thuan
AU  - Nguyen DT
AD  - Department of Plastic Surgery, Catharina Hospital, Eindhoven, Netherlands.
FAU - Verhees, Rianne P M
AU  - Verhees RP
AD  - Department of Radiology, Catharina Hospital, Eindhoven, Netherlands.
FAU - Mihl, Casper
AU  - Mihl C
AD  - Department of Radiology, Catharina Hospital, Eindhoven, Netherlands.
FAU - Verberkmoes, Niels Y
AU  - Verberkmoes NY
AD  - Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands.
FAU - van Straten, Albert H M
AU  - van Straten AH
AD  - Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands.
FAU - Soliman Hamad, Mohamed A
AU  - Soliman Hamad MA
AD  - Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands 
      aasmsn@cze.nl.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20140330
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
CIN - Interact Cardiovasc Thorac Surg. 2014 Jul;19(1):9-10. PMID: 24944317
MH  - Adolescent
MH  - Adult
MH  - Arterial Occlusive Diseases/diagnostic imaging/etiology/*physiopathology
MH  - Constriction, Pathologic
MH  - *Device Removal
MH  - Equipment Design
MH  - Female
MH  - Funnel Chest/*surgery
MH  - Humans
MH  - Male
MH  - Mammary Arteries/diagnostic imaging/*physiopathology
MH  - Multidetector Computed Tomography
MH  - Orthopedic Procedures/adverse effects/*instrumentation
MH  - Prospective Studies
MH  - Reoperation
MH  - Treatment Outcome
MH  - *Vascular Patency
MH  - Young Adult
OTO - NOTNLM
OT  - Computed tomography angiography
OT  - Internal mammary artery
OT  - Pectus excavatum
EDAT- 2014/04/02 06:00
MHDA- 2015/02/11 06:00
CRDT- 2014/04/02 06:00
PHST- 2014/04/02 06:00 [entrez]
PHST- 2014/04/02 06:00 [pubmed]
PHST- 2015/02/11 06:00 [medline]
AID - ivu083 [pii]
AID - 10.1093/icvts/ivu083 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2014 Jul;19(1):6-9. doi: 10.1093/icvts/ivu083. 
      Epub 2014 Mar 30.