Yeungnam Univ J Med.  2019 Sep;36(3):260-264. 10.12701/yujm.2019.00241.

Late complication of the Nuss procedure: recurrent cardiac tamponade

• Park WJ
• Son JW
• Park KH
• Kim YM
• Nam JH
• Choi KU
• Kim JH

• KMID: 2460196
• DOI: http://doi.org/10.12701/yujm.2019.00241

Abstract

Pectus excavatum (PE) is known as one of the most common congenital deformities of the anterior chest wall. The Nuss procedure is an effective surgical therapy to correct PE. Here, we report a case of recurrent cardiac tamponade due to hemopericardium that occurred after 16 months following the Nuss procedure. The cause of recurrent hemopericardium was thought to be local, repetitive irritation of the pericardium by the Nuss steel bar. We should keep in mind that this serious complication can occur after the Nuss procedure, even in the late phase.

Keyword

Cardiac tamponade; Complication; Nuss procedure; Pectus excavatum

MeSH Terms

Cardiac Tamponade*
Congenital Abnormalities
Funnel Chest
Pericardial Effusion
Pericardium
Steel
Thoracic Wall
Steel

Figure

• 

  Fig. 1. Transthoracic echocardiography findings of her first emergency department visit show a moderate amount of pericardial effusion with tamponade. (A) A moderate amount of pericardial effusion (arrowheads) with the diastolic collapse of the right ventricle (star). (B) Respiratory variation of mitral inflow exceeding 25%. (C) Expiratory diastolic hepatic vein flow reversal (arrowheads). (D) Dilated inferior vena cava with a plethora (arrow).

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  Fig. 2. Transthoracic echocardiography findings of her second emergency department visit. Note all the tamponade physiologies are present, even with a small amount of pericardial effusion. (A) A small amount of pericardial effusion in subcostal view. (B) Respiratory variation of mitral inflow exceeding 25%. (C) Expiratory diastolic hepatic vein flow reversal (arrowheads). (D) Dilated inferior vena cava with a plethora (arrow).

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  Fig. 3. Chest computed tomography showing contact of the Nuss bar (arrowheads) and pericardium (arrows).

Reference

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