Aortic surgery in Marfan patients with severe pectus excavatum

J Cardiovasc Med (Hagerstown). 2017 May;18(5):305-310. doi: 10.2459/JCM.0000000000000394.


Aims: The optimal surgical management of the aortic root phenotype Marfan patients with severe pectus excavatum is a subject of debate. All the available literature were reviewed according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) principles in order to assess the early outcomes of both pectus excavatum and aortic repair techniques.

Methods: Searches were done in PubMed and MEDLINE electronic databases dating from July 1953 to December 2015.

Results: A total of 97 peer-reviewed publications were retrieved, and 27 relevant publications were identified with a total of 39 Marfan patients with pectus excavatum who underwent ascending aorta and aortic root surgery. Emergency acute Type-A aortic dissection repair was reported in five cases. Concomitant pectus excavatum and aortic root repair and composite graft implantation were the most commonly performed procedures. Complications after a staged or a combined approach were uncommon and no deaths occurred.

Conclusion: Aortic surgery in Marfan patients with pectus excavatum was carried out according to a variety of strategies, surgical techniques and accesses with low complications rate and no mortality. Many of these were well tolerated with minimal complications and no mortality.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / etiology
  • Aortic Aneurysm / surgery*
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Female
  • Funnel Chest / complications
  • Funnel Chest / diagnostic imaging
  • Funnel Chest / surgery*
  • Humans
  • Male
  • Marfan Syndrome / complications*
  • Marfan Syndrome / diagnosis
  • Middle Aged
  • Orthopedic Procedures* / adverse effects
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Sternum / abnormalities
  • Sternum / diagnostic imaging
  • Sternum / surgery*
  • Treatment Outcome
  • Young Adult