Compression brace for secondary pectus carinatum in infants and toddlers undergoing cardiac surgery with midline sternotomy

• Published in: General thoracic and cardiovascular surgery Vol. 72; no. 11; pp. 718 - 725
• Main Authors: Konishi, Hayato, Fujiwara, Kenta, Okazaki, Sayaka, Suzuki, Akiyo, Suzuki, Tatsuya, Katsumata, Takahiro, Nagano, Toru, Nemoto, Shintaro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.11.2024; Springer Nature B.V
• Subjects: Cardiac Surgery; Cardiology; Cartilage; Child development; Heart surgery; Medicine; Medicine & Public Health; Original; Original Article; Patients; Rib cage; Surgical Oncology; Thoracic Surgery; Toddlers; Japan; Compression brace; Cardiac surgery; Midline sternotomy; Pectus carinatum
• ISSN: 1863-6705; 1863-6713; 1863-6713
• DOI: 10.1007/s11748-024-02030-0

Purposes This study aimed to retrospectively assess the response to a newly developed compression brace for improving the deformity of the secondary pectus carinatum in infants and toddlers undergoing cardiac surgery with midline sternotomy. Factors affecting the response to the brace were identified. Methods Fifty-one children were enrolled. Severity was expressed as the protrusion angle of the sternum obtained from chest X-ray. The patients were divided into two groups by positive or negative binary residuals of the relationship between the angle at the beginning and its percentage change after wearing the brace. Logistic regression analysis was used to identify the influencing factors. Results Thirty patients (58.8%) showed zero and positive residuals to the relationship (good responders, Group G), whereas 21 patients showed negative residuals (poor responders, Group P). Male sex, severe cardiac anomaly, complex surgical procedure, multiple sternotomy, total duration, and self-discontinuation were associated with poor response to the brace by univariate analysis. The first three factors remained with high odds ratio for poor response by multivariate analysis. No adverse events occurred with the brace. Conclusion Our newly developed compression brace contributed, at least in part, to improve the deformity of the secondary pectus carinatum. Further studies are required to clarify the therapeutic efficacy of anterior chest compression for secondary pectus carinatum.