Simultaneous pectus excavatum repair using sternal plate in a patient undergoing the Bentall procedure

Abstract

Objective: Pectus excavatum is a deformity that occurs at the lower part of the sternum of the thorax, including the xiphoid process. Deformity generally causes cosmetic and psychosocial problems. Life-threatening conditions may ensue in patients with severe deformities. Ravitch surgery and Nuss's minimally invasive surgical procedures are the main procedures for correcting the pectus excavatum. A rare method of pectus excavatum is the stabilization of the sternum by using sternal plates. In this report, we present a case; successful pectus excavatum repair using the sternal plate simultaneously in a 48-year-old male patient who underwent Bentall operation due to ascending aortic aneurysm and aortic valve insufficiency. Case presentation: The patient was admitted with complaint of dyspnea. Examinations including clinical examinations, echocardiography, computed tomography  and pulmonary tests revealed pectus excavatum, with Haller index&qt;3.5,   reduced forced vital capacity 72% and ascending aorta aneurysm of 5.7 cm and moderate aortic valve regurgitation. The decision  to proceed with simultaneous aortic root and aortic valve replacement with pectus excavatum correction was taken. The operation were performed successfully under cardiopulmonary bypass without complications. Patient was discharged  on 9th postoperative day. Conclusion: In patients with pectus excavatum deformity who undergo cardiac surgery (in our case ascending aorta and aortic valve replacement) with median sternotomy, simultaneous sternal repair using a sternal plate is safe and preferable because it positively affects cardiac and pulmonary surgical outcomes. Therefore, we recommend simultaneous sternal plate application in patients with pectus excavatum who will have a cardiac operation.