Senica Simone Oliver, Gasparella Paolo, Soldatenkova Ksenija, Smits Lauris, Ābola Zane
Faculty of Medicine, Riga Stradins University, Riga 1007, Latvia.
Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz 8036, Austria.
J Surg Case Rep. 2022 Nov 26;2022(11):rjac538. doi: 10.1093/jscr/rjac538. eCollection 2022 Nov.
Life-threatening complications (LTCs) and negative results of surgical treatments often go unreported. Minimally invasive repair of pectus excavatum (MIRPE) represents a procedure with a low incidence of adverse outcomes. However, 15 potentially fatal cases of MIRPE-related heart injury have been published. We report a case of cardiac perforation (CP) during MIRPE. A 12-year-old female was admitted for elective repair of a severe asymmetric pectus excavatum. Preoperative computed tomography showed a Haller index of 4.9. MIRPE was performed under bilateral video-assisted thoracoscopy. After the placement of the pectus bar, cardiac arrhythmias, hypotension and bilateral hemothorax occurred. Emergency thoracotomy without pectus bar removal showed CP. The wound sites were repaired and the pectus bar was eventually successfully implanted. The patient was discharged on postoperative day 11. After 10 months, she remains asymptomatic. Reporting rare complications is essential for accurate calculations of the true prevalence of LTCs, maintaining high alertness in pediatric surgeons.
危及生命的并发症（LTCs）以及手术治疗的负面结果常常未被报告。漏斗胸微创修复术（MIRPE）是一种不良后果发生率较低的手术。然而，已有15例与MIRPE相关的潜在致命性心脏损伤病例被发表。我们报告1例MIRPE期间发生心脏穿孔（CP）的病例。一名12岁女性因择期修复严重不对称漏斗胸入院。术前计算机断层扫描显示哈勒指数为4.9。在双侧电视辅助胸腔镜下进行MIRPE。放置鸡胸矫正钢板后，出现心律失常、低血压和双侧血胸。未取出鸡胸矫正钢板的急诊开胸手术显示有CP。伤口部位得到修复，鸡胸矫正钢板最终成功植入。患者于术后第11天出院。10个月后，她仍无症状。报告罕见并发症对于准确计算LTCs的真实患病率至关重要，这能使小儿外科医生保持高度警惕。
