How is pulmonary function improved in pectus excavatum?

Updated: Oct 30, 2018
  • Author: Andre Hebra, MD; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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A prospective study of preoperative and postoperative pulmonary function following corrective surgery for pectus excavatum found that there is significant improvement in lung function at rest and in VO2 max and O2 pulse after surgical correction of pectus excavatum, with CT index >3.2. According to the study, operative correction significantly reduces CT index and markedly improves the shape of the entire chest and can be performed safely in a variety of centers. [3] ] ,[ [4] In 1984, Cahill et al reported that, after operative repair, lung capacity improved little, and maximal voluntary ventilation significantly improved in patients with pectus excavatum who had low-to-normal vital capacities prior to surgery. [5] Exercise tolerance was also improved, as measured by total exercise time and maximal oxygen uptake. The heart rate at a given level of work or exercise consistently decreased postoperatively, but oxygen consumption to support an improved efficiency of work was not changed.The observed decrease in heart rate at each workload capacity was a result of increased cardiac stroke volume.

In 1967, Weg et al evaluated 25 US Air Force recruits with pectus excavatum and compared them with healthy trainees. [6] Although the lung compartments and mean vital capacities of both groups were equal, the maximum voluntary ventilation significantly deviated from predicted reference range values (P = 0.005).

In 1996, Quigley et al studied 36 adolescents (mean age 16 y) with pectus excavatum. [7] Quigley et al reported a significantly lower forced vital capacity in the study group than in an age-matched control group. Moreover, an inverse relationship was observed between the vital capacity and the degree of sternal compression, suggesting that such patients would benefit from operative correction of the pectus deformity.

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