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J Thorac Cardiovasc Surg 2003;126:2081-2082
© 2003 The American Association for Thoracic Surgery

Brief communication

Videothoracoscopic extrapleural insertion of walter lorenz surgical bar for pectus excavatum

Helena Hernández, MDa, Andres Varela, PhD*,a, Mar Cordoba, MDa, Luis Madrigal, PhDa, Mariano Artes, MD,a

a Department of Cardiothoracic Surgery, Division of General Thoracic Surgery, Hospital Puerta de Hierro, Madrid, Spain

Received for publication February 25, 2002; accepted for publication September 4, 2002.

* Address for reprints: Andrés Varela, PhD, Department of Cardiothoracic Surgery, Division of General Thoracic Surgery, C/San Martín de Porres, 4, 28035 Madrid, Spain
avarelade@hpth.insalud.es

The first 20% of the full text of this article appears below.


Varela, Hernández, Gámez, Córdoba, Madrigal


Since 1949, the standard for correction of pectus excavatum is the Ravitch procedure1 and the modifications that have been introduced over time. The operation includes either subperichondrial incision or excision of involved cartilage and transverse osteotomy of the sternum, with or without an internal support or some prosthetic appliance.2 In 1997, a new minimally invasive technique for correction of pectus excavatum based on orthopedic principles was introduced by Nuss and associates.3 The new procedure avoids the anterior chest wall incision and requires neither sternal osteotomy nor excision of any rib cartilage.

The pectus support bar rapidly gained in acceptance among pediatric and thoracic surgeons. However, some complications were reported,4,5 including pericarditis, cardiac injury, and anterior thoracic artery pseudoaneurysm. In an attempt to minimize the morbidity, we introduced a modification to the Nuss . . . [Full Text of this Article]






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