Abstract:
INTRODUCTION:Pectus excavatum is commonly viewed as a benign condition. Associated alterations in hemodynamics are rare. We present an unusual case of right ventricular inflow obstruction and hemodynamic compromise as a consequence of pectus excavatum encountered during surgical intervention. CASE:a 15-year-old male with pectus excavatum and thoracolumbar scoliosis developed severe hypotension after induction of general anesthesia and placement in the prone position for elective spinal fusion. A transesophageal echocardiogram revealed anterior compression of the right heart by the sternum with peak and mean right ventricular inflow gradients of 7 and 4 mm Hg, respectively. The gradient resolved with supine positioning and was reproduced with direct compression of the sternum. CONCLUSIONS:Although pectus excavatum is generally a benign condition, the cardiologist should be aware of the potential for serious hemodynamic compromise related to positioning in these patients.
journal_name
Congenit Heart Disjournal_title
Congenital heart diseaseauthors
Galas JM,van der Velde ME,Chiravuri SD,Farley F,Parra D,Ensing GJdoi
10.1111/j.1747-0803.2008.00231.xsubject
Has Abstractpub_date
2009-05-01 00:00:00pages
193-5issue
3eissn
1747-079Xissn
1747-0803pii
CHD231journal_volume
4pub_type
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