Syncope caused by right ventricular obstruction by pectus excavatum

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Presentation transcript:

Syncope caused by right ventricular obstruction by pectus excavatum Suzanne Borrhomée, MD, Marien Lenoir, MD, Marielle Gouton, MD, Elie Fadel, MD The Journal of Thoracic and Cardiovascular Surgery Volume 151, Issue 4, Pages e67-e69 (April 2016) DOI: 10.1016/j.jtcvs.2015.10.018 Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Computed tomographic scan of the chest wall. A and B, Preoperative view showing the chest wall deformity with the heart adherent to the sternum, causing severe compression of the right ventricle and right ventricular outflow tract, as well as associated with tricuspid valve stenosis from leaflet involvement. C and D, Postoperative computed tomographic scan showing the heart no longer compressed by the sternum. The Journal of Thoracic and Cardiovascular Surgery 2016 151, e67-e69DOI: (10.1016/j.jtcvs.2015.10.018) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Diagram showing the hypothesized effects of previous sternotomy on the heart in pectus excavatum. A, Normal thorax. B, Pectus excavatum (PE) without sternotomy, with the heart shifted to the left side of the chest without deformation. C, Pectus excavatum after sternotomy, with the heart compressed between the sternum and spine, resulting in right ventricular deformation. The Journal of Thoracic and Cardiovascular Surgery 2016 151, e67-e69DOI: (10.1016/j.jtcvs.2015.10.018) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions

Diagram showing result of previous sternotomy on the heart in pectus excavatum. The Journal of Thoracic and Cardiovascular Surgery 2016 151, e67-e69DOI: (10.1016/j.jtcvs.2015.10.018) Copyright © 2016 The American Association for Thoracic Surgery Terms and Conditions