Details

Autor(en) / Beteiligte

• Maagaard, Marie, MS
• Tang, Mariann, MD, PhD
• Ringgaard, Steffen, MSc, PhD
• Nielsen, Hans Henrik M., MD, PhD
• Frøkiær, Jørgen, MD, PhD
• Haubuf, Maj, MD
• Pilegaard, Hans K., MD
• Hjortdal, Vibeke E., MD, PhD

Titel

Normalized Cardiopulmonary Exercise Function in Patients With Pectus Excavatum Three Years After Operation

Ist Teil von

• The Annals of thoracic surgery, 2013-07, Vol.96 (1), p.272-278

Ort / Verlag

Netherlands: Elsevier Inc

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Background During exercise cardiac function is often limited in patients with pectus excavatum. Therefore, we hypothesized that cardiopulmonary exercise function would improve after the Nuss procedure. Methods Seventy-five teenagers (49 patients, 26 controls) were investigated at rest and during bicycle exercise before surgery, and 1 year and 3 years postoperatively (after pectus-bar removal). Echocardiography and lung spirometry were performed at rest. Cardiac output, heart rate, and aerobic exercise capacity were measured using a photoacoustic gas-rebreathing technique during rest and exercise. Results Forty-four patients and 26 controls completed 3 years follow-up. Preoperatively, patients had lower maximum cardiac index, mean ±SD, 6.6 ± 1.2 l·min-1 ·m−2 compared with controls 8.1 ± 1.0 l·min-1 ·m−2 during exercise ( p  = 0.0001). One year and 3 years postoperatively, patients' maximum cardiac index had increased significantly and after 3 years there was no difference between patients and controls (8.1 ± 1.2 l·min-1 ·m−2 and 8.3 ± 1.6 l·min-1 ·m−2 , respectively [ p  = 0.572]). The maximum oxygen consumption was unchanged. Left ventricular dimensions increased in patients over 3 years; however, no difference was seen between the 2 groups. Preoperatively, patients had lower forced expiratory volume in the first second of expiration (FEV1 ; 86% ± 13%) as compared with controls (94% ± 10%), p  = 0.009. Postoperatively, no difference was found in FEV1 between the 2 groups. Conclusions Before operation, FEV1 and maximum cardiac index were lower in patients compared with healthy, age-matched controls. One year after, both parameters had increased, although only FEV1 had normalized. After 3 years and bar removal, cardiopulmonary function in patients during exercise had normalized.