Surgical Indications and Management of Pectus Excavatum

Special Considerations in Patient Evaluation

• Complete cardiac evaluation is mandatory when genetic syndromes are suspected, particularly in patients with connective tissue disorders such as Marfan syndrome or Noonan syndrome, according to the American College of Cardiology 1
• In Marfan syndrome patients, pectus excavatum scores 1 point in the systemic features scoring system, and these patients require thorough aortic assessment, as recommended by the American Heart Association 2
• Noonan syndrome patients may have pectus excavatum along with cardiac alterations such as pulmonary stenosis, highlighting the need for comprehensive evaluation, as suggested by the American Academy of Pediatrics 1
• Patients with kyphoscoliosis and pectus excavatum may have cardiac migration to the left hemithorax, which affects surgical planning, according to the Scoliosis Research Society 1
• Osteogenesis imperfecta patients with pectus excavatum may have more severe restrictive respiratory patterns, necessitating careful preoperative assessment, as recommended by the Orthopaedic Surgeons 1