Clinical Observation Of Simultaneous Surgery Of The Simple Congenital Heart Disease And Pectus Xcavatum

Objective:To explore the surgery method and feasibility of simultaneous surgery of the simple congenital heart disease(CHD)with pectus excavatum(PE),and summarize the clinical experience.Methods:A retrospective study was carried out on 11 children of the simple CHD with PE,that simultaneous surgery was done between 2012-04-01 and 2017-01-01 in our children’s hospital.There were 7 boys and 4 girls in these patients.The age ranged from 5 years and 2 months old to 10 years and 6 months old(mean age 7.56±3.30 years old).The average weight was 18.40±6.75Kg(ranging 13.5～31.0 Kg).This case group included 4 cases of atrial septal defect(ASD),3 cases of ventricular septal defect(VSD),3 cases of atrial septal defect(ASD)and ventricular septal defect(VSD)and 1 case of patent ductus arteriosus(PDA)。The patient of patent ductus arteriosus with the suture surgery of patent ductus arteriosus in the condition of controlled hypotension;3 cases of atrial septal defect in children with atrial septal defect closure surgery with the guidance of the transesophageal echocardiography;the remaining children were in the routine cardiopulmonary bypass atrial septal defect repair surgery or(and)ventricular septal defect repair surgery.All of the 11 patients underwent sternal elevation surgery after the surgery of congenital heart disease.As control group,11 single cases of CHD were randomly selected with the same age,weight and surgical procedures during the same period.The total operation duration,the time of postoperative analgesia,the time in ICU,the volume of ostoperative chest drainage,duration of postoperative chest tube,postoperative hospitalization duration,complication and operation effect were analyzed in both groups.Results:All of the patients in the group were cured.The time of postoperation hospitalization duration was from 6 days to 15 days,average 8.32±4.55 days,none of them suffered serious complication such as incision infection and abnormal breathing and so on.All patients’ appearance of chest were fine,and maintain original thoracic configuration during the follow up time from 5 months to 4 years.UCG reviewed that hearts functioned well,all were I class(NYHA),and there was no residual shunt found.There was statistical difference in operation time between the case group and the simple congenital heart disease group(P<0.05);and there was no statistical significance in postoperative care time,postoperative mediastinal drainage time,drainage volume and postoperation hospitalization duration between the two groups(P>0.05).The complications of the two groups had no significant difference(P>0.05).Conclusion:Simultaneous surgery of the simple CHD with PE did not increase the risk of surgery,complications and postoperative recovery time,the surgery treatment during the same period is safe and feasible;And it avoided reoperation risks of anesthesia and the difficulties brought by the second operation,reduced the medical costs,relieved the pain of children.