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Sternal torsion in pectus excavatum is related to cardiac compression and chest malformation indexes.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2020 Apr; Vol. 55 (4), pp. 619-624. Date of Electronic Publication: 2019 May 16. - Publication Year :
- 2020
-
Abstract
- Background/purpose: The role of sternal torsion (ST) in patients with pectus excavatum (PEX) is unknown. We evaluated the relationship between ST and both chest malformation and cardiac compression (CC) indexes.<br />Methods: We included consecutive patients with PEX who underwent chest computed tomography and cardiac magnetic resonance (CMR) to define surgical candidacy. Malformation indexes included the Haller index (HI), correction index (CI), and ST. CC and the tricuspid to mitral annulus width ratio were evaluated using CMR.<br />Results: One-hundred and sixteen patients were included, with a mean HI of 5.8 ± 3.6 and a mean CI of 35.8 ± 18.0%. ST was significantly related to malformation indexes, being patients with absence of ST those showing the lowest HI (p = 0.048) and CI (p = 0.002). Right-sided ST was significantly related to the CC classification (p = 0.0001), and the tricuspid/mitral annulus width ratio was significantly lower among these patients (absence 0.98 ± 0.15, left-sided 0.91 ± 0.10, right-sided 0.80 ± 0.15, p < 0.0001). A significant inverse relationship between ST degrees and the tricuspid/mitral ratio was also identified (r = -0.47, p < 0.0001).<br />Conclusions: We identified a significant relationship between ST and both chest malformation and CC indexes; the absence of ST being identified as a marker of an overall more benign phenotype.<br />Type of Study: Study of diagnostic test.<br />Level of Evidence: Level II.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Female
Funnel Chest diagnostic imaging
Funnel Chest surgery
Heart diagnostic imaging
Humans
Magnetic Resonance Imaging
Male
Myocardium pathology
Phenotype
Pressure
Retrospective Studies
Severity of Illness Index
Sternum diagnostic imaging
Tomography, X-Ray Computed
Torsion Abnormality diagnostic imaging
Young Adult
Funnel Chest pathology
Sternum pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 55
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31133283
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2019.05.008