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J Thorac Cardiovasc Surg 2009;138:1240-1241
© 2009 The American Association for Thoracic Surgery

Brief Technique Report

Near-fatal bleeding after transmyocardial ventricle lesion during removal of the pectus bar after the Nuss procedure

^a Division of Pediatric Surgery, University Children's Hospital, Basel, Switzerland
^b Division of Thoracic Surgery, University Hospital, Basel, Switzerland

Received for publication June 28, 2008; accepted for publication July 17, 2008.

^_* Address for reprints: Frank-Martin Haecker, MD, Associate Professor of Pediatric Surgery, University Children's Hospital, Department of Pediatric Surgery, PO Box, CH-4005 Basel, Switzerland. (Email: frankmartin.haecker@ukbb.ch).

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

	Introduction

 
In 1998, the technique of minimally invasive repair of pectus excavatum (MIRPE) was first described by Nuss et al.¹ This procedure is reported to be less invasive and to achieve cosmetically better results than conventional surgery, and has been introduced in many centers.^2,3 Because of the widespread use of MIRPE, pediatric surgeons are faced with a new spectrum of complications.^2-5 Cardiac perforation represents a rare but potentially serious condition that has to be taken into consideration when dealing with MIRPE. There are several reports of cardiac perforation during implantation of a pectus bar within the MIRPE procedure.^2,3,5 However, this is the first report of a life-threatening transmyocardial ventricle lesion during removal of the bar.

	Clinical Summary

 
We report on a 20-year-old woman who had undergone thoracotomy and cardiac surgery for transposition of great vessels and mild pulmonary valve stenosis (Mustard technique) at the age of 18 months. Fifteen years later, she presented . . . [Full Text of this Article]