2012 annual meeting & cardiothoracic forum - Society for ...

JOINT ANNUAL MEETING 2012 ABSTRACTS
081 Outcome of Chest Wall Deformity Repair Using Ravitch
Procedure Without Sternal Support Bar
Authors: R.S. George; K. Papagiannopoulos
St James’s University Hospital, United Kingdom
Objective: Chest wall deformity imposes a serious cosmetic problem and
depending on severity can be associated with respiratory and cardiovascular
complications. Traditional Ravitch procedure is the standard surgical approach with
the use of metal bars to eliminate postoperative flail chest and to reduce pain.
However, sternal bars have been associated with multiple complications and often
require a second anaesthetic for removal. The purpose of this study is to evaluate
the post-operative outcome of metal free Ravitch repair against the use of any
metal support.
Methods: Between October 2006 and August 2011, 58 patients underwent Ravitch
procedure: 28 pectus excavatum and 30 pectus carinatum. 41 patients (Group 1)
did not have a pectus bar; instead a gortex patch or marlex mesh fashioned into
‘hammock’ shape was used. The remaining 17 (Group 2) had a pectus bar
implanted: 14 for pectus excavatum and 3 for pectus carinatum.
Results: Group1 patients were younger (20.7±6.4 years vs 25.5±10.5 years,
p=NS) with more females (34.1% vs 23.5%, p=NS). Post-operative length of stay
was similar between both groups (5.4±1.5 days vs 6.7±3.1 days, p=0.12). Six
(14.6%) group 1 patients developed procedure related complications as compared
to 10 (58.8%) from group 2 (x2=11.7, p