The utility of echocardiography and pulmonary function testing in the preoperative evaluation of pectus excavatum

被引:7
作者
Ganescu, Olivia [1 ]
LaRusso, Kathryn [1 ]
St-Louis, Etienne [1 ]
Saint-Martin, Christine [2 ]
Cavalle-Garrido, Tiscar [3 ]
Zielinski, David [4 ]
Laberge, Jean-Martin [1 ,5 ]
Emil, Sherif [1 ,5 ]
机构
[1] McGill Univ, Montreal Childrens Hosp, Harvey E Beardmore Div Pediat Surg, Hlth Ctr, Montreal, PQ, Canada
[2] McGill Univ, Montreal Childrens Hosp, Div Pediat Radiol, Hlth Ctr, Montreal, PQ, Canada
[3] McGill Univ, Montreal Childrens Hosp, Div Pediat Cardiol, Hlth Ctr, Montreal, PQ, Canada
[4] McGill Univ, Montreal Childrens Hosp, Div Pediat Respirol, Hlth Ctr, Montreal, PQ, Canada
[5] Shriners Hosp Children Canada, Chest Wall Anomaly Ctr, Montreal, PQ, Canada
关键词
Pectus excavatum; Pulmonary function testing; Echocardiography; SURGICAL REPAIR; IMPACT; PREVALENCE; VALVE;
D O I
10.1016/j.jpedsurg.2021.12.010
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Purpose: Echocardiography (ECHO) and pulmonary function testing (PFT) are routinely performed during the preoperative evaluation of pectus excavatum (PE). We hypothesized that these investigations may be performed selectively based on patient symptoms and pectus severity. Methods: A retrospective review of all PE patients who underwent a Nuss procedure during a 15-year period (2004-2018) was conducted. Symptoms, clinical characteristics, ECHO, and PFT results were ex-tracted from the medical chart. PE severity on computed tomography was measured using the Haller In-dex (HI) and Correction Index (CI), and reported as mean +/- SEM. Logistic and linear regression assessed the ability of symptoms and indices to predict abnormal cardiopulmonary test results. Results: Of 119 patients, 116 patients had symptom documentation, and 74 (64%) had one or more symp-toms. HI and CI were 3.8 +/- 1.0 and 31.6 +/- 10.3, respectively. Of those with ECHO available (111), 14 (13%) were abnormal, and 12 of 14 required cardiology follow-up. Of those with PFT available (90), the results were abnormal in 15 (17%), including 9 (11%) obstructive, 4 (5%) restrictive, and 2 (2%) mixed. The pres-ence of symptoms did not predict abnormal ECHO or PFT, but each standard deviation increase in the CI was associated with abnormal PFT and ECHO by a factor of 2.2 and 2.0 respectively. HI severity was only associated with ECHO. Conclusion: The rates of abnormal ECHO and PFT testing in PE patients are low, and do not correlate with symptoms. Routine ECHO is still recommended to detect anomalies requiring follow-up. Elevated CI severity may be used to guide selective PFT testing. (C) 2021 Elsevier Inc. All rights reserved.
引用
收藏
页码:1561 / 1566
页数:6
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