The use of vacuum bell therapy for the treatment of pectus excavatum in children of the younger group: the dynamics of changes in echocardiography

Authors

DOI:

https://doi.org/10.15574/PP.2024.97.78

Keywords:

congenital defects, children, chest deformity, conservative treatment, echocardiography, pediatrics

Abstract

Pectus excavatum (PE) si common disease among children, which in most cases manifests during the period of intensive growth. Children with PE may have asymptomatic changes in the heart and may not cause concern for some time.

Purpose - to evaluate of the dynamics of echocardiography changes during conservative treatment of PE by vacuum bell therapy.

Materials and methods. An evaluation of 28 patients with an average age of 6.4±1.2, who underwent conservative treatment of PE, was carried out. Cardiac ultrasound data before and after treatment were processed statistically.

Results. After treatment, signs of mitral valve prolapse in children remained, that is, there were no qualitative changes. But the overall level of prolapse decreased statistically significantly (p=0.042) from 1.97±0.87 mmHg. to 1.73±0.69 mm Hg. Paradoxical movement of the interventricular membrane was not a frequent defect and before treatment was observed only in 5 (17.9%) children. After treatment, this defect was not noted.

Myocardial function in all children was normal (>60%) both before treatment (69.86±8.21%) and after (68.54±2.67%).

Conclusions. In pediatric population disturbances in the work of the heart with PE are often in a compensated or subcompensated state, but in the future they can lead to functional disorders.Screening use of echocardiography is recommended for all children with manifestations of funnel-shaped chest deformity.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research.

No conflict of interests was declared by the authors.

References

Abid I, Ewais MM, Marranca J, Jaroszewski DE. (2017). Pectus Excavatum: A Review of Diagnosis and Current Treatment Options. J Am Osteopath Assoc. 117(2): 106-113. https://doi.org/10.7556/jaoa.2017.021; PMid:28134952

Acipayam A, Güllü UU, Güngör Ş. (2023). Cardiac anomalies in pediatric patients with pectus excavatum. Rev Assoc Med Bras (1992). 69(7): e20221301. https://doi.org/10.1590/1806-9282.20221301; PMid:37466586 PMCid:PMC10352011

Daemen JHT, de Loos ER, Geraedts TCM, Van Veer H, Van Huijstee PJ, Elenbaas TWO et al. (2022). Visual diagnosis of pectus excavatum: An inter-observer and intra-observer agreement analysis. J Pediatr Surg. 57(3): 526-531. https://doi.org/10.1016/j.jpedsurg.2021.06.003; PMid:34183157

Gürkan U, Aydemir B, Aksoy S, Akgöz H, Tosu AR, Öz D et al. (2014). Echocardiographic assessment of right ventricular function before and after surgery in patients with pectus excavatum and right ventricular compression. Thorac Cardiovasc Surg. 62(3): 231-235. https://doi.org/10.1055/s-0033-1342941; PMid:23619591

Jung Y, Yi E, Lee K, Chung JH, Cho S, Lee S. (2021). Surgical versus Vacuum Bell Therapy for the Correction of Pectus Excavatum: A Comparison of 1-Year Treatment Outcomes. J Chest Surg. 54(6): 473-479. https://doi.org/10.5090/jcs.21.073; PMid:34815370 PMCid:PMC8646059

Koumbourlis AC. (2015). Pectus deformities and their impact on pulmonary physiology. Paediatr Respir Rev. 16(1): 18-24. https://doi.org/10.1016/j.prrv.2014.10.009; PMid:25464892

Kovalenko VM, Sychov OS, Dolzhenko MM, Ivaniv YuA, Nesukai OH, Potashev SV. (2016). Ekhokardiohrafichna otsinka klapannykh stenoziv. Rekomendatsii robochoi hrupy z funktsionalnoi diahnostyky Asotsiatsii kardiolohiv Ukrainy ta Vseukrainskoi asotsiatsii fakhivtsiv z ekhokardiohrafii. URL: https://www.webcardio.org/ekhokardioghrafichna-otsinka-klapannykh-stenoziv.aspx.

Loufopoulos I, Karagiannidis IG, Lampridis S, Mitsos S, Panagiotopoulos N. (2021). Vacuum Bell: Is It a Useful Innovative Device for Pectus Excavatum Correction? Turk Thorac J. 22(3): 251-256. https://doi.org/10.5152/TurkThoracJ.2021.20035; PMid:35110237 PMCid:PMC8975307

Park JM, Varma SK. (1990). Pectus excavatum in children: diagnostic significance for mitral valve prolapse. Indian J Pediatr. 57(2): 219-22. https://doi.org/10.1007/BF02722092; PMid:2246020

St-Louis E, Miao J, Emil S, Baird R, Bettolli M, Montpetit K et al. (2019). Vacuum bell treatment of pectus excavatum: An early North American experience. J Pediatr Surg. 54(1): 194-199. https://doi.org/10.1016/j.jpedsurg.2018.10.011; PMid:30414687

Published

2024-03-28