Zhang Ruoyu, Hagl Christian, Bobylev Dmitry, Breymann Thomas, Schmitto Jan D, Haverich Axel, Krüger Marcus
Hannover Medical School, Carl-Neuberg-Str, 1, 30625 Hannover, Germany.
J Cardiothorac Surg. 2011 Mar 30;6:40. doi: 10.1186/1749-8090-6-40.
We present a case of sternal steel strut dislodgement and migration in a patient undergoing Ravitch repair for pectus excavatum (PE) 37 years ago. Broken struts perforated the right ventricle and right ventricular outflow tract (RVOT) and additionally migrated into the left upper lobar bronchus.Dislodged sternal struts represent rare complications after surgical repair of patients suffering from pectus excavatum. Reviewing the literature, only five cases of intrapericardial migration of dislodged sternal struts or wires have been reported so far.In our case, the first strut was removed from the airways through a left antero-lateral thoracotomy. Using cardiopulmonary bypass, a second strut was removed via ventriculotomy. These life-threatening sequelae underscore the importance of postoperative follow-up and early removal of osteosynthetic materials used in open PE repair. Accurate preoperative localization of migrated materials and availability of CPB support are crucial for successful surgical removal.
The migration of dislodged sternal steel struts or wires into the pericardium and cardiac cavities is a rare but life-threatening complication of open pectus excavatum (PE) repair 1. Removal of these materials poses a challenge for cardiothoracic surgeons. Herein, the authors report a case of migration of dislodged steel struts through the right ventricle and right ventricular outflow tract (RVOT) into the left upper lobar bronchus in a patient who underwent Ravitch repair 37 years ago.
我们报告一例37年前接受Ravitch手术治疗漏斗胸（PE）的患者发生胸骨钢支撑移位和迁移的病例。断裂的支撑穿透右心室和右心室流出道（RVOT），并额外迁移至左上叶支气管。移位的胸骨支撑是漏斗胸手术修复后罕见的并发症。查阅文献，迄今为止仅报道了5例移位的胸骨支撑或钢丝在心包内迁移的病例。在我们的病例中，通过左前外侧开胸术从气道取出了第一根支撑。使用体外循环，通过心室切开术取出了第二根支撑。这些危及生命的后遗症强调了术后随访以及早期取出开放性漏斗胸修复术中使用的骨合成材料的重要性。术前准确确定迁移材料的位置以及体外循环支持的可用性对于成功进行手术取出至关重要。
移位的胸骨钢支撑或钢丝迁移至心包和心腔内是开放性漏斗胸（PE）修复术罕见但危及生命的并发症1。取出这些材料对心胸外科医生构成挑战。在此，作者报告一例37年前接受Ravitch手术的患者，移位的钢支撑通过右心室和右心室流出道（RVOT）迁移至左上叶支气管的病例。
