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Ann Thorac Surg 2006;81:1913-1915
© 2006 The Society of Thoracic Surgeons

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Combined Severe Pectus Excavatum Correction and Aortic Root Replacement in Marfan's Syndrome

Kalyana C. Javangula, FRCS * , Timothy J.P. Batchelor, AFRCS, Osama Jaber, MD, Kevin G. Watterson, FRACS, Kostas Papagiannopoulos, MD (CTH)

Department of Cardiothoracic Surgery, Leeds General Infirmary, Leeds, United Kingdom

Accepted for publication March 8, 2005.

* Address correspondence to Dr Javangula, Department of Cardiothoracic Surgery, Leeds General Infirmary, Great George St, Leeds, LS1 3EX UK (Email: kalyanachakravarthi{at}hotmail.com).

A 23-year-old man with Marfan's syndrome was admitted for repair of annulo-aortic ectasia and severe pectus excavatum. A submammary skin incision approach followed by bilateral subperichondrial resection of abnormal costal cartilages was performed. The left intercostal muscles and perichondrial sheaths were divided 2 inches lateral to the sternum in a parasternal fashion to place the retractor. The aortic root was replaced with a 23-mm St. Jude's composite graft (St. Jude Medical, Inc, St. Paul, MN). Chest wall reconstruction was completed with a high sternal osteotomy and support of the sternum was made with Gortex strips (W.L. Gore & Associates, Inc, Flagstaff, AZ). The patient made an uneventful recovery.






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