RT Journal Article
SR Electronic
T1 Evaluation of the effects of surgical correction of left mediastinal displacement in children with pectus excavatum on pulmonary perfusion, using minimal radiation exposure
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 177
VO 40
IS Suppl 56
A1 Shinya Shimoyama
A1 Tohru Kobayashi
A1 Kentaro Ikeda
A1 Mitsuru Seki
A1 Hiroyuki Mochizuki
A1 Akito Hamajima
A1 Shinitu Hatakeyama
A1 Tomio Kobayashi
A1 Hirokazu Arakawa
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/177.abstract
AB The pulmonary perfusion(PP) in pectus excavatum (PE) patients after surgery hasn't been objectively assessed.Objectives: To investigate the effects of surgical repaire of left mediastinal displacement in children with PE on PP, using easily performed and minimally invasive methods which minimize radiation exposure. Methods: We prospectively evaluated 34 consecutive patients with PE pre- and post-Nuss procedure using chest radiography (CXR), echocardiography(UCG), and PP scintigraphy. CXR was used to calculate the vertebral index (VI) and left displacement index (LDI, ratio between the distance from the left border of the mediastinum to the left border of the thorax and the transverse thoracic dimension on posteroanterior CXR). PP scintigraphy was visually interpreted and left-to-right count ratio (Ls/Rs) was measured. Pre-ejection period, acceleration time (AcT), and ejection time (ET) of the right pulmonary artery (RPA) and left pulmonary artery (LPA) were measured by pulse Doppler UCG. Results: VI and LDI improved postoperatively (P<0.001). Preoperatively, left PP was impaired. Postoperatively, Ls/Rs increased (P=0.001) and AcT/ET changed (LPA: P<0.001; RPA: P=0.008). Evaluation of the usefulness of CXR showed that LDI correlated with Ls/Rs (R=0.411, P<0.001) and LPA-AcT/ET (R=0.50, P<0.001), and that VI did not correlate with Ls/Rs and correlated poorly with LPA-AcT/ET (R= -0.28, P<0.05). Conclusions: The imbalance of PP improves after the Nuss procedure. The degree of leftward displacement of the mediastinum correlates with decreased left PP. Follow-up can be achieved with minimal radiation exposure.