Clinical Significance of Cardiac Structure and Function Evaluation by Cardiac Magnetic Resonance Imaging for Patients with Pectus Excavatum at Preoperation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

XUBo ¹ ,  LIUJi-fu ¹ , GEMing-mei ² , TANJian ¹ , WUBing ² , YEJin-duo ³ , MAJing-bo ¹ , ZHANGChun-qiu ³

1. Department of Thoracic Surgery, General Hospital of Beijing Army District, PLA., Beijing 100700, P. R. China;
2. Department of Radiology, General Hospital of Beijing Army District, PLA., Beijing 100700, P. R. China;
3. Department of Biomechanics, Tianjin University of Technology, Tianjin 300384, P. R. China;

Corresponding author：

LIUJi-fu, Email: liujf200809@sina.com

Keywords：

Pectus excavatum; Cardiac magnetic resonance imaging; Cardiac structure and function; Perioperation

DOI：

10.7507/1007-4848.20150215

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Objective To investigate the changes and clinical significance of cardiac structure and function evaluation by cardiac magnetic resonance imaging (CMR) for patients with pectus excavatum deformity at preoperation. Methods We retrospectively analyzed 54 patients (24 children and 30 adults) who underwent pectus excavatum surgery from June 2012 to June 2014. There were 48 males and 6 females at age of 7-33 (19.08±5.17) years. All the patients underwent CMR using 1.5 Tesla scanner for evaluation of compressing and displacement of the heart. The major and minor dimensions of right ventricle were measured. The right ventricle end-diastole volume (RVEDV), right ventricle end-systolic volume (RVESV), and right ventricle ejection fraction (RVEF) were also recorded and analyzed. Results The heart compression and displacement occurred in 83.3% of the children group and 90.0% of the adults group. The extent of heart displacement in the adults was more serious than that in the children (76.86%±13.30% vs. 67.99%±8.15%, P<0.05). The structure of right ventricle were striking distorted because right atrum or right ventricule below valve ring was compressed locally, with the major dimension of right ventricle obviously increased, and the minor dimension of right ventricle obviously decreased. The indices of right ventricle major dimension and right ventricle minor dimension were 61.14±0.44 mm/m² and 14.82±2.52 mm/m² in the children, 49.54±15.40 mm/m² and 18.90 ±3.14 mm/m² in the adults. The RVEDV and RVESV were significantly higher in the adults than those in the children (139.09±29.08 ml vs. 121.50±31.27 ml; 73.61±16.05 ml vs. 64.92±19.28 ml; P<0.05). RVEF was similar between the children and the adults (45.29%±4.14% vs. 46.30±6.09%). The patients' symptoms disappeared after correction of pectus excavatum. Conclusion CMR is an useful method for evaluating right ventricular structure and functions in patients with cardiac compression and distortion by pectus excavatum before operation, which can bring strong indications for pectus excavatum repair surgery.

Citation： XUBo, LIUJi-fu, GEMing-mei, TANJian, WUBing, YEJin-duo, MAJing-bo, ZHANGChun-qiu. Clinical Significance of Cardiac Structure and Function Evaluation by Cardiac Magnetic Resonance Imaging for Patients with Pectus Excavatum at Preoperation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(9): 862-865. doi: 10.7507/1007-4848.20150215 Copy

1.	刘吉福, 徐波, 武珊珊. 微创手术矫治儿童漏斗胸后胸廓骨重塑与临床疗效. 中国胸心血管外科临床杂志, 2012, 19(1):39-42.
2.	Yalamanchili K, Summer W, Valentine V, et al. Pectus excavatum with inspiratory inferior vena cava compression:a new presentation of pulsus paradoxus. Am J Med Sci, 2005, 329(1):45-47.
3.	Guntheroth WG, Spier PS. Cardiac function before and after surgery for pectus excavatum. Am J Cardiol, 2008, 101(5):743.
4.	周璐, 金征宇, 张竹花, 等. 心脏磁共振成像评价健康志愿者心脏的结构和功能. 中国医学科学院学报, 2009, 31(2):210-214.
5.	Saleh RS, Finn JP, Fenchel M, et al. Cardiaovascular magnetic resonance in patients with pectus excavatum compared with normal controls. J Cardiov Magn Reson, 2010, 12(1):73-83.
6.	Kelly RE, Goretsky MJ, Obermeyer R, et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1215 patients. Ann Surg, 2010, 252(6):1072-1081.
7.	Humphries CM, Anderson JL, Flores JH, et al. Cardiac magnetic resonance imaging for perioperation evaluation of sternal eversion for pectus excavatum. Eur J Cardiothorac Surg, 2013, 43(6):1110-1113.
8.	Maagaard M, Tang M, Ringgaard S, et al. Normalized cardiopulmonary exercise function in patients with pectus excavatum three years after operation. Ann Thorac Surg, 2013, 96(1):272-278.
9.	Quigley PM, Haler JA Jr, Jelus KL, et al. Cardiorespiratory function before and after corrective surgery in pectus excavatum. J Pediatr, 1996, 128(5 Pt 1):638-643.
10.	Sehata ML, Cheng S, Osman NF, et al. Myocardial tissue tagging with cardiovascular magnetic resonance. J Cardiovas Magn Reson, 2009, 11:55.
11.	Chen SS, Keegan J, Dowsey AW, et al. Cardiovascular magnetic resonance tagiing of the right ventricular free wall for the assessment of long axis myocardioal function in congenital heart disease. J Cardiov Magn Reson, 2011, 13(1):80-89.

1. 刘吉福, 徐波, 武珊珊. 微创手术矫治儿童漏斗胸后胸廓骨重塑与临床疗效. 中国胸心血管外科临床杂志, 2012, 19(1):39-42.
2. Yalamanchili K, Summer W, Valentine V, et al. Pectus excavatum with inspiratory inferior vena cava compression:a new presentation of pulsus paradoxus. Am J Med Sci, 2005, 329(1):45-47.
3. Guntheroth WG, Spier PS. Cardiac function before and after surgery for pectus excavatum. Am J Cardiol, 2008, 101(5):743.
4. 周璐, 金征宇, 张竹花, 等. 心脏磁共振成像评价健康志愿者心脏的结构和功能. 中国医学科学院学报, 2009, 31(2):210-214.
5. Saleh RS, Finn JP, Fenchel M, et al. Cardiaovascular magnetic resonance in patients with pectus excavatum compared with normal controls. J Cardiov Magn Reson, 2010, 12(1):73-83.
6. Kelly RE, Goretsky MJ, Obermeyer R, et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1215 patients. Ann Surg, 2010, 252(6):1072-1081.
7. Humphries CM, Anderson JL, Flores JH, et al. Cardiac magnetic resonance imaging for perioperation evaluation of sternal eversion for pectus excavatum. Eur J Cardiothorac Surg, 2013, 43(6):1110-1113.
8. Maagaard M, Tang M, Ringgaard S, et al. Normalized cardiopulmonary exercise function in patients with pectus excavatum three years after operation. Ann Thorac Surg, 2013, 96(1):272-278.
9. Quigley PM, Haler JA Jr, Jelus KL, et al. Cardiorespiratory function before and after corrective surgery in pectus excavatum. J Pediatr, 1996, 128(5 Pt 1):638-643.
10. Sehata ML, Cheng S, Osman NF, et al. Myocardial tissue tagging with cardiovascular magnetic resonance. J Cardiovas Magn Reson, 2009, 11:55.
11. Chen SS, Keegan J, Dowsey AW, et al. Cardiovascular magnetic resonance tagiing of the right ventricular free wall for the assessment of long axis myocardioal function in congenital heart disease. J Cardiov Magn Reson, 2011, 13(1):80-89.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Significance of Cardiac Structure and Function Evaluation by Cardiac Magnetic Resonance Imaging for Patients with Pectus Excavatum at Preoperation

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