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Emergent Pectus Excavatum Repair After Aortic Root Replacement in Marfan Patient

Authors

  • Elizabeth H. Stephens M.D., Ph.D.,

    1. Texas Heart Institute at St. Luke's Episcopal Hospital, and Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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  • Ourania Preventza M.D.,

    1. Texas Heart Institute at St. Luke's Episcopal Hospital, and Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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  • Cristian S. Sarateanu M.D.,

    1. Texas Heart Institute at St. Luke's Episcopal Hospital, and Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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  • Scott A. LeMaire M.D.,

    Corresponding author
    1. Texas Heart Institute at St. Luke's Episcopal Hospital, and Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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  • Joseph S. Coselli M.D.

    1. Texas Heart Institute at St. Luke's Episcopal Hospital, and Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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  • Conflict of interest: No conflict of interest.

Scott A. LeMaire, M.D., Baylor College of Medicine, One Baylor Plaza, BCM 390, Houston, TX 77030. Fax: 832-355-9948; e-mail: slemaire@bcm.edu

Abstract

Abstract  Chest wall deformities, including pectus excavatum, can complicate cardiac operations by impeding sternal entry and cardiac exposure and by affecting cardiac hemodynamic performance. We describe a patient with Marfan syndrome who underwent elective replacement of an aortic root aneurysm. The patient required a simultaneous, unplanned, emergent repair of her severe pectus excavatum because of hemodynamic instability after sternal closure. The success of this procedure suggests that emergent single-stage repair of pectus excavatum should be considered when median sternotomy closure precipitates hemodynamic instability in such patients.

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