Simultaneous Surgical Repair of Severe Pectus Excavatum Associated with Mitral Regurgitation, Angina Pectoris and Left Atrial Tumor for an Old Non-Marfan Patient

Akane Mihara

Tomohiro Mizuno and Hirokuni Arai

（Department of Cardiovascular Surgery, Machida Municipal Hospital, Tokyo, Japan, Present address:Department of Cardiovascular Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan, and Department of Cardiovascular Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan）

Patients requiring simultaneous surgical repair for severe pectus excavatum and cardiac disease are rare, and most are children with congenital heart disease and chest deformity or young adults with Marfan syndrome. We experienced an old non-Marfan patient who had cardiac disease associated with severe pectus excavatum which needed thoracoplasty to approach the heart. A 69-year-old man with pectus excavatum was admitted because of dyspnea. We diagnosed acute congestive heart failure due to severe mitral regurgitation. A left atrial tumor and coronary artery disease were also diagnosed. Because of severe pectus, the heart was displaced to the left lower chest cavity. The distance between the sternum and the vertebrae was only 1cm. It was impossible to approach the heart without thoracoplasty. We simultaneously performed mitral valve replacement, 3-vessel coronary artery bypass grafting, resection of the left atrial tumor and thoracoplasty. His postoperative course was uneventful.

 

Jpn. J. Cardiovasc. Surg. 43:200-204（2014）

Keywords：pectus excavatum:mitral regurgitation;angina pectoris;Marfan syndrome