Department of Thoracic and Cardiovascular Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-0801, Japan.
Doi Orthopedic Clinic, Takatsuki, Osaka, Japan.
Gen Thorac Cardiovasc Surg. 2024 Nov;72(11):718-725. doi: 10.1007/s11748-024-02030-0. Epub 2024 Apr 25.
This study aimed to retrospectively assess the response to a newly developed compression brace for improving the deformity of the secondary pectus carinatum in infants and toddlers undergoing cardiac surgery with midline sternotomy. Factors affecting the response to the brace were identified.
Fifty-one children were enrolled. Severity was expressed as the protrusion angle of the sternum obtained from chest X-ray. The patients were divided into two groups by positive or negative binary residuals of the relationship between the angle at the beginning and its percentage change after wearing the brace. Logistic regression analysis was used to identify the influencing factors.
Thirty patients (58.8%) showed zero and positive residuals to the relationship (good responders, Group G), whereas 21 patients showed negative residuals (poor responders, Group P). Male sex, severe cardiac anomaly, complex surgical procedure, multiple sternotomy, total duration, and self-discontinuation were associated with poor response to the brace by univariate analysis. The first three factors remained with high odds ratio for poor response by multivariate analysis. No adverse events occurred with the brace.
Our newly developed compression brace contributed, at least in part, to improve the deformity of the secondary pectus carinatum. Further studies are required to clarify the therapeutic efficacy of anterior chest compression for secondary pectus carinatum.
本研究旨在回顾性评估一种新开发的压缩支具对接受正中胸骨切开术心脏手术的婴儿和幼儿的继发鸡胸畸形的改善效果。确定影响支具反应的因素。
共纳入 51 名患儿。严重程度采用胸骨 X 线片获得的胸骨突出角表示。根据佩戴支具前后角度的关系的二元残差为零或阳性，将患者分为两组。采用 logistic 回归分析确定影响因素。
30 名患者（58.8%）的关系呈零和阳性残差（良好反应组，G 组），而 21 名患者呈阴性残差（不良反应组，P 组）。单因素分析显示，男性、严重心脏畸形、复杂手术、多次正中切开、总持续时间和自行中断与支具反应不良有关。多因素分析显示，前三个因素与不良反应的高比值比相关。支具无不良事件发生。
我们新开发的压缩支具至少部分有助于改善继发鸡胸畸形。需要进一步研究来阐明前胸压迫治疗继发鸡胸的疗效。
