- The use of vacuum bell therapy for the treatment of pectus excavatum in children of the younger group: the dynamics of changes in echocardiography
The use of vacuum bell therapy for the treatment of pectus excavatum in children of the younger group: the dynamics of changes in echocardiography
Ukrainian Journal of Perinatology and Pediatrics. 2024. 1(97): 78-83. doi: 10.15574/PP.2024.97.78
Yaroslavska S. M. 1, Kryvopustov S. P.1, Saltykova G. V.1, Pismennyi V. D.1, Boyko N. S.1, Shidlovska I. V.2
1Bogomolets National Medical University, Kyiv, Ukraine
2National Children’s Specialized Hospital «OKHMATDYT», Kyiv, Ukraine
For citation: Yaroslavska SM, Kryvopustov SP, Saltykova GV, Pismennyi VD, Boyko NS, Shidlovska IV. (2024). The use of vacuum bell therapy for the treatment of pectus excavatum in children of the younger group: the dynamics of changes in echocardiography. Ukrainian Journal of Perinatology and Pediatrics. 1(97): 78-83. doi: 10.15574/PP.2024.97.78.
Article received: Dec 19, 2023. Accepted for publication: Mar 12, 2024.
Pectus excavatum (PE) si common disease among children, which in most cases manifests during the period of intensive growth. Children with PE may have asymptomatic changes in the heart and may not cause concern for some time.
Purpose – to evaluate of the dynamics of echocardiography changes during conservative treatment of PE by vacuum bell therapy.
Materials and methods. An evaluation of 28 patients with an average age of 6.4±1.2, who underwent conservative treatment of PE, was carried out. Cardiac ultrasound data before and after treatment were processed statistically.
Results. After treatment, signs of mitral valve prolapse in children remained, that is, there were no qualitative changes. But the overall level of prolapse decreased statistically significantly (p=0.042) from 1.97±0.87 mmHg. to 1.73±0.69 mm Hg. Paradoxical movement of the interventricular membrane was not a frequent defect and before treatment was observed only in 5 (17.9%) children. After treatment, this defect was not noted.
Myocardial function in all children was normal (>60%) both before treatment (69.86±8.21%) and after (68.54±2.67%).
Conclusions. In pediatric population disturbances in the work of the heart with PE are often in a compensated or subcompensated state, but in the future they can lead to functional disorders.Screening use of echocardiography is recommended for all children with manifestations of funnel-shaped chest deformity.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research.
No conflict of interests was declared by the authors.
Keywords: congenital defects, children, chest deformity, conservative treatment, echocardiography, pediatrics.
REFERENCES
1. Abid I, Ewais MM, Marranca J, Jaroszewski DE. (2017). Pectus Excavatum: A Review of Diagnosis and Current Treatment Options. J Am Osteopath Assoc. 117(2): 106-113. https://doi.org/10.7556/jaoa.2017.021; PMid:28134952
2. Acipayam A, Güllü UU, Güngör Ş. (2023). Cardiac anomalies in pediatric patients with pectus excavatum. Rev Assoc Med Bras (1992). 69(7): e20221301. https://doi.org/10.1590/1806-9282.20221301; PMid:37466586 PMCid:PMC10352011
3. Daemen JHT, de Loos ER, Geraedts TCM, Van Veer H, Van Huijstee PJ, Elenbaas TWO et al. (2022). Visual diagnosis of pectus excavatum: An inter-observer and intra-observer agreement analysis. J Pediatr Surg. 57(3): 526-531. https://doi.org/10.1016/j.jpedsurg.2021.06.003; PMid:34183157
4. Gürkan U, Aydemir B, Aksoy S, Akgöz H, Tosu AR, Öz D et al. (2014). Echocardiographic assessment of right ventricular function before and after surgery in patients with pectus excavatum and right ventricular compression. Thorac Cardiovasc Surg. 62(3): 231-235. https://doi.org/10.1055/s-0033-1342941; PMid:23619591
5. Jung Y, Yi E, Lee K, Chung JH, Cho S, Lee S. (2021). Surgical versus Vacuum Bell Therapy for the Correction of Pectus Excavatum: A Comparison of 1-Year Treatment Outcomes. J Chest Surg. 54(6): 473-479. https://doi.org/10.5090/jcs.21.073; PMid:34815370 PMCid:PMC8646059
6. Koumbourlis AC. (2015). Pectus deformities and their impact on pulmonary physiology. Paediatr Respir Rev. 16(1): 18-24. https://doi.org/10.1016/j.prrv.2014.10.009; PMid:25464892
7. Kovalenko VM, Sychov OS, Dolzhenko MM, Ivaniv YuA, Nesukai OH, Potashev SV. (2016). Ekhokardiohrafichna otsinka klapannykh stenoziv. Rekomendatsii robochoi hrupy z funktsionalnoi diahnostyky Asotsiatsii kardiolohiv Ukrainy ta Vseukrainskoi asotsiatsii fakhivtsiv z ekhokardiohrafii. URL: https://www.webcardio.org/ekhokardioghrafichna-otsinka-klapannykh-stenoziv.aspx.
8. Loufopoulos I, Karagiannidis IG, Lampridis S, Mitsos S, Panagiotopoulos N. (2021). Vacuum Bell: Is It a Useful Innovative Device for Pectus Excavatum Correction? Turk Thorac J. 22(3): 251-256. https://doi.org/10.5152/TurkThoracJ.2021.20035; PMid:35110237 PMCid:PMC8975307
9. Park JM, Varma SK. (1990). Pectus excavatum in children: diagnostic significance for mitral valve prolapse. Indian J Pediatr. 57(2): 219-22. https://doi.org/10.1007/BF02722092; PMid:2246020
10. St-Louis E, Miao J, Emil S, Baird R, Bettolli M, Montpetit K et al. (2019). Vacuum bell treatment of pectus excavatum: An early North American experience. J Pediatr Surg. 54(1): 194-199. https://doi.org/10.1016/j.jpedsurg.2018.10.011; PMid:30414687