Original Articles
Assessment of cases of funnel chest managed with Ravitchs procedure | |
Dr. Subhash Balara | |
Background: Funnel chest, medically known as pectus excavatum, is a congenital deformity of the chest wall where the breastbone (sternum) and ribs grow abnormally, causing a depression or caved-in appearance in the center of the chest. The present study was conducted to assess cases of funnel chest managed with Ravitch's procedure. Materials & Methods: 54 cases of funnel chest of both genders were enrolled. Parameters such as degrees of depression, asymmetry, and flatteness ofthe chest wall was recorded. All were subjected to echocardiography. All underwent Ravitch's surgical procedure. A preoperative and post- operative CT of the chest wall was done to compare outcome of treatment Results: Out of 54 patients, males were 34 and females were 20. Degree of depression before and after operation was 2.40 and 2.98, degree of asymmetry was 0.97 and 0.91 and degree of flatness was 1.82 and 1.14 respectively. The difference was significant (P< 0.05). Electrocardiographic abnormalities were incomplete right bundle branch block in 20, complete right bundle branch block in 13, ventricular premature beat in 10, arterial premature beat in 7 and atrioventricular block in 4 cases. The difference was significant (P< 0.05). Conclusion: An operation to lengthen the ribs would be required to improve the degree of a/b, a transient support with struts should be used in patients with a severely depressed funnel chest, as expressed by a b/c value over 3.0 on computed tomography, and finally, a more cautious approach for asymmetry correction should be taken to improve the surgical outcomes. Key words: bundle branch, Electrocardiographic, Funnel chest |
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