Pectus Carinatum as a Sequela of Minimally Invasive Pectus Excavatum Repair

Abstract

Reported complications of minimally invasive repair of pectus excavatum (MIRPE) include bar displacement, pneumothorax, pleural effusion, and, rarely, thoracic outlet syndrome, pericarditis, major blood loss, cardiac dysrhythmias, cardiac injury, sternal erosion, and pseudoaneurysm. A 13-year-old boy with severe pectus excavatum (chest index 3.7) underwent MIRPE resulting in 100% correction of the chest wall abnormality. One year after MIRPE, the patient acquired a very pronounced pectus carinatum. Despite immediate removal of the pectus bar, the pectus carinatum was persistent for 2 months. The complication of pectus carinatum 1 year following MIRPE is rare and presents unique management dilemmas. Careful postoperative follow-up after MIRPE is recommended to identify patients at risk for development of a carinatum-like deformity so that bar removal can be performed in a timely fashion to halt or reverse the protrusion process.