Eur J Cardiothorac Surg. 2025 Dec 13:ezaf444. doi: 10.1093/ejcts/ezaf444. Online ahead of print.
ABSTRACT
OBJECTIVES: Dynamic compression bracing (DCB) systems have been proven safe and effective for a non-surgical treatment of Pectus Carinatum (PC). This study aimed to identify potential prognostic factors for PC correction using DCB.
METHODS: From 2011 to 2020, all patients treated with DCB for PC at the University Hospital of Saint-Etienne were retrospectively reviewed. The primary outcome was a reduction ≤ 50% in pectus height (PH) at 6 months follow-up, measured by radiation-free imaging. Two statistical models adjusted for compliance with treatment were used.
RESULTS: A total of 297 patients were treated with DCB (mean age: 15.4 ± 3.9 years). 42% of deformities were symmetrical. Baseline mean PH and pressure for initial correction (PIC) were 2.97 ± 1.02 cm and 6.5 ± 2.0 psi, respectively. The median total treatment duration was 13.1 months (9.2-17.9). Among the 114 (46.5%) patients with available PH data, the median decrease in PH was -35.8% (-62.4% to -10.0%) after 6 months of DCB, with 61 patients (53.5%) achieving a reduction ≥ 50% in PH. In multivariate analysis, only PIC (OR = 1.34; 95% CI: 1.09 to 1.64; p = 0.005) was significantly associated with PH reduction in model 1, and PIC ≥ 7.5 psi (OR = 2.53; 95% CI: 1.13 to 5.67; p = 0.024) in model 2. Patient compliance was 85.2% at 6 months. The recurrence rate was 11.3% (n = 26).
CONCLUSIONS: The PIC value appears to be a potential prognosis factor for PH reduction after 6 months of DCB treatment. These results will be validated in an ongoing prospective study.
CLINICAL TRIAL: The study was approved by the Ethical Committee “Terres d’Ethique” (IRBN902020/CHUSTE) and registered at Clinicaltrials.gov (NCT04452721).
PMID:41390917 | DOI:10.1093/ejcts/ezaf444
