Management of Internal Mammary Artery Injuries Associated With the Nuss Procedure

Am Surg. 2023 Aug;89(8):3503-3504. doi: 10.1177/00031348231161696. Epub 2023 Mar 7.

Abstract

The minimally invasive repair of pectus excavatum (MIRPE), or Nuss procedure, is regarded as the gold standard technique for the treatment of symptomatic pectus excavatum. Minimally invasive repair of pectus excavatum is regarded as a low-risk operation with a reported life-threatening complication rate estimated at around 0.1%. Presented are three cases of right internal mammary artery injury (RIMA) after MIRPE resulting in massive hemorrhage in both the acute and chronic postoperative setting and subsequent management strategies. Exploratory thoracoscopy and angioembolization were utilized which achieved prompt hemostasis and allowed for complete patient recovery.

Keywords: Pediatric surgery; thoracic surgery.

MeSH terms

  • Funnel Chest* / surgery
  • Hemorrhage / surgery
  • Humans
  • Mammary Arteries* / surgery
  • Minimally Invasive Surgical Procedures / methods
  • Plastic Surgery Procedures*
  • Retrospective Studies
  • Thoracoscopy / methods
  • Treatment Outcome