The influence of 10-year Nuss bar placement on bar removal: a case report
Abstract Background The Nuss bar is commonly used for minimally invasive correction of pectus excavatum and is usually removed within 2–3 years. Here, we report a case of 10-year bar placement after the Nuss procedure accompanied by unique complications of thoracic malformation that have not been de...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-02021-3 |
| _version_ | 1828096231558086656 |
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| author | Haihua Gu Guanxin Xu Tianshu Liu Sai Zhang |
| author_facet | Haihua Gu Guanxin Xu Tianshu Liu Sai Zhang |
| author_sort | Haihua Gu |
| collection | DOAJ |
| description | Abstract Background The Nuss bar is commonly used for minimally invasive correction of pectus excavatum and is usually removed within 2–3 years. Here, we report a case of 10-year bar placement after the Nuss procedure accompanied by unique complications of thoracic malformation that have not been described before. The asymmetric pectus carinatum caused by bar displacement and significant rib periosteal hyperplasia is described for the first time. Case presentation A 23-year-old man was admitted to our hospital due to the main complaint of obvious chest discomfort when lifting heavy weights. The bar removal was seriously delayed due to his loss to follow-up. Chest asymmetry and distant heart sounds were found during a physical examination. A chest CT scan demonstrated that the right end of the lower bar originally fixed outside the ribs had shifted into the thoracic cavity, and the left costal cartilage was obviously protruding. Additionally, the displaced bars were separated from the sternum and tightly attached to the pericardium, resulting in abnormalities of the anterior mediastinum. These secondary thoracic deformities made the patient extremely prone to massive hemorrhage or multiple rib fractures when sliding the bars out. However, serious consequences were avoided due to reasonable adjustments to the usual bar removal procedures. Conclusion This case demonstrates a specific type of bar displacement caused by prolonged placement of the bars and highlights the importance of rigorous follow-up of patients after the Nuss procedure. |
| first_indexed | 2024-04-11T07:27:07Z |
| format | Article |
| id | doaj.art-13ede6e0d7ac491eaaeb9372080aaa18 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-11T07:27:07Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-13ede6e0d7ac491eaaeb9372080aaa182022-12-22T04:37:02ZengBMCJournal of Cardiothoracic Surgery1749-80902022-10-011711410.1186/s13019-022-02021-3The influence of 10-year Nuss bar placement on bar removal: a case reportHaihua Gu0Guanxin Xu1Tianshu Liu2Sai Zhang3Department of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang UniversityDepartment of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang UniversityDepartment of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang UniversityDepartment of Thoracic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang UniversityAbstract Background The Nuss bar is commonly used for minimally invasive correction of pectus excavatum and is usually removed within 2–3 years. Here, we report a case of 10-year bar placement after the Nuss procedure accompanied by unique complications of thoracic malformation that have not been described before. The asymmetric pectus carinatum caused by bar displacement and significant rib periosteal hyperplasia is described for the first time. Case presentation A 23-year-old man was admitted to our hospital due to the main complaint of obvious chest discomfort when lifting heavy weights. The bar removal was seriously delayed due to his loss to follow-up. Chest asymmetry and distant heart sounds were found during a physical examination. A chest CT scan demonstrated that the right end of the lower bar originally fixed outside the ribs had shifted into the thoracic cavity, and the left costal cartilage was obviously protruding. Additionally, the displaced bars were separated from the sternum and tightly attached to the pericardium, resulting in abnormalities of the anterior mediastinum. These secondary thoracic deformities made the patient extremely prone to massive hemorrhage or multiple rib fractures when sliding the bars out. However, serious consequences were avoided due to reasonable adjustments to the usual bar removal procedures. Conclusion This case demonstrates a specific type of bar displacement caused by prolonged placement of the bars and highlights the importance of rigorous follow-up of patients after the Nuss procedure.https://doi.org/10.1186/s13019-022-02021-3Pectus excavatumNuss bar removalPectus carinatumCase report |
| spellingShingle | Haihua Gu Guanxin Xu Tianshu Liu Sai Zhang The influence of 10-year Nuss bar placement on bar removal: a case report Journal of Cardiothoracic Surgery Pectus excavatum Nuss bar removal Pectus carinatum Case report |
| title | The influence of 10-year Nuss bar placement on bar removal: a case report |
| title_full | The influence of 10-year Nuss bar placement on bar removal: a case report |
| title_fullStr | The influence of 10-year Nuss bar placement on bar removal: a case report |
| title_full_unstemmed | The influence of 10-year Nuss bar placement on bar removal: a case report |
| title_short | The influence of 10-year Nuss bar placement on bar removal: a case report |
| title_sort | influence of 10 year nuss bar placement on bar removal a case report |
| topic | Pectus excavatum Nuss bar removal Pectus carinatum Case report |
| url | https://doi.org/10.1186/s13019-022-02021-3 |
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