Cardiovascular MRI assessment of pectus excavatum in pediatric patients and postoperative simulation using vacuum bell

• Published in: Journal of pediatric surgery 2021-09, Vol.56 (9), p.1600-1605
• Main Authors: Stagnaro, Nicola, Trocchio, Gianluca, Torre, Michele, Rizzo, Francesca, Martucciello, Giuseppe, Marasini, Maurizio
• Format: Article
• Language: English
• Subjects: Magnetic resonance imaging; Pectus excavatum; Thoracic malformation; Vacuum bell
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2020.11.017

The sternal lift by Vacuum Bell (VB) is effective, as largely demonstrated by its intraoperative use during surgical procedure to elevate the sternum during the Nuss procedure routinely. Indeed, the thoracic remodelling during VB application is comparable to post-surgical scenario, and suitable to compare cardiovascular parameters of the two different thoracic configurations immediately. We would quantify and correlate preoperative parameters which determine the severity of the pectus excavatum (PE), and the cardiovascular effects at the baseline. Than we would assess the cardiovascular changes during VB positioning, mimicking the immediate, temporary effect of Pectus-correction. We included 26 consecutive patients (mean age is 13,3 +/- 2,2 years) symptomatic and non, with a previous clinical diagnosis of PE. CMR was performed before and during application of VB, using the same imaging protocol. In both conditions, we measured thoracic indexes, and cardiac function as well as flow through main vessels. Mean expiratory Haller Index (HI) was 5,4 (+/-1,4 SD; normal