TY - CHAP M1 - Book, Section TI - Pectus Excavatum A1 - Frantz, Frazier W. A1 - Goretsky, Michael J. A1 - Shamberger, Robert C. A2 - Ziegler, Moritz M. A2 - Azizkhan, Richard G. A2 - Allmen, Daniel von A2 - Weber, Thomas R. PY - 2014 T2 - Operative Pediatric Surgery, 2e AB - Surgical repair of pectus excavatum is indicated for patients with a severe pectus deformity and associated physiologic impairment.Cardiorespiratory impairment associated with severe pectus excavatum has been characterized and measured by pulmonary function testing, morphologic and functional echocardiographic assessment, cardiovascular magnetic resonance imaging (CMR), and incremental exercise testing.Relief of cardiac compression after pectus repair is associated with increased stroke volumes and subsequent improvements in exercise capacity and cardiovascular performance.The optimal timing for pectus excavatum repair appears to be 10 to 14 years of age, when the chest wall is still malleable. Repairs done in this age range are associated with a low incidence of recurrent pectus excavatum.The Nuss procedure is now used for the majority of primary pectus excavatum repairs.Open repair is used primarily for patients with severe asymmetry of the chest wall, mixed pectus deformities, or if there are objections to having a substernal bar in place for 2 to 3 years.Both the Nuss procedure and open repair methods provide excellent results with low complication and recurrence rates. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1100432512 ER -