Cardiac Function Assessed by Transesophageal Echocardiography During Pectus Excavatum Repair

Background We assessed end-diastolic right ventricular (RV) dimensions and left ventricular (LV) ejection fraction by use of intraoperative transesophageal echocardiography before and after surgical correction of pectus excavatum in adults. Methods A prospective study was conducted including 17 patients undergoing surgical correction of pectus excavatum according to the technique of Ravitch-Shamberger between 1999 and 2004. Intraoperative transesophageal echocardiography was performed under general anesthesia before and after surgery to assess end-diastolic RV dimensions and LV ejection fraction. The end-diastolic RV diameter and area were measured in four-chamber and RV inflow-outflow view, and the RV volume was calculated from these data. The LV was assessed by transgastric short-axis view, and its ejection fraction was calculated by use of the Teichholz formula. Results The end-diastolic RV diameter, area, and volume all significantly increased after surgery (mean values ± SD, respectively: 2.4 ± 0.8 cm versus 3.0 ± 0.9 cm, p < 0.001; 12.5 ± 5.2 cm2 versus 18.4 ± 7.5 cm2 , p < 0.001; and 21.7 ± 11.7 mL versus 40.8 ± 23 mL, p < 0.001). The LV ejection fraction also significantly increased after surgery (58.4% ± 15% versus 66.2% ± 6%, p < 0.001). Conclusions Surgical correction of pectus excavatum according to Ravitch-Shamberger technique results in a significant increase in end-diastolic RV dimensions and a significantly increased LV ejection fraction.