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Heart, Lung and Circulation

Novel Nuss Bar Fixation Using ZipFix for Pectus Excavatum

Published:February 03, 2022DOI:https://doi.org/10.1016/j.hlc.2021.12.012

      Background

      Bar displacement is one of the most serious complications following the Nuss procedure for pectus excavatum repair. This paper reports a novel method of bar fixation using ZipFix, a biocompatible cable-tie implant, and shares a series of patients and outcomes.

      Methods

      This paper describes the ZipFix stabilisation method and presents a case series of 20 patients with pectus excavatum who underwent the Nuss procedure and ZipFix stabilisation between July 2015 and September 2020.

      Results

      A total of 34 ZipFixes were implanted in 20 patients. Six (6) patients had one ZipFix placed and 14 patients had two ZipFixes implanted: 13 were bilateral and one patient had two ZipFixes placed on the right. There was one incidence of asymptomatic posterior superior displacement of the right bar. Two (2) patients had wound infections and one patient had a previously placed bar adjusted and secured with a ZipFix. All patients had full correction of their chest wall deformity with no recurrence.

      Conclusions

      This case series shows that the use of ZipFix for Nuss bar fixation is feasible using this technique.

      Keywords

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      References

        • Nuss D.
        Minimally invasive surgical repair of pectus excavatum.
        Semin Pediatr Surg. 2008; 17: 209-217
        • Nuss D.
        • Kelly R.E.
        Indications and techniques of Nuss procedure for pectus excavatum.
        Thorac Surg Clin. 2010; 20: 583-597
        • Grapow M.T.
        • Melly L.F.
        • Eckstein F.S.
        • Reuthebuch O.T.
        A new cable-tie based sternal closure system: description of the device, technique of implantation and first clinical evaluation.
        J Cardiothorac Surg. 2012; 7: 1-5
        • Croitoru D.P.
        • Kelly Jr., R.E.
        • Goretsky M.J.
        • Lawson M.L.
        • Swoveland B.
        • Nuss D.
        Experience and modification update for the minimally invasive Nuss technique for pectus excavatum repair in 303 patients.
        J Pediatr Surg. 2002; 37: 437-445
        • Hebra A.
        • Gauderer M.W.
        • Tagge E.P.
        • Adamson W.T.
        • Othersen Jr., H.B.
        A simple technique for preventing bar displacement with the Nuss repair of pectus excavatum.
        J Pediatr Surg. 2001; 36: 1266-1268
        • Pilegaard H.K.
        • Licht P.B.
        Early results following the Nuss operation for pectus excavatum – a single-institution experience of 385 patients.
        Interact Cardiovasc Thorac Surg. 2008; 7: 54-57
        • Jacobs J.P.
        • Quintessenza J.A.
        • Morell V.O.
        • Botero L.M.
        • van Gelder H.M.
        • Tchervenkov C.I.
        Minimally invasive endoscopic repair of pectus excavatum.
        Eur J Cardiothorac Surg. 2002; 21: 869-873
        • Park H.J.
        • Lee S.Y.
        • Lee C.S.
        • Youm W.
        • Lee K.R.
        The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients.
        Ann Thorac Surg. 2004; 77: 289-295
        • Banever G.T.
        • Tashjian D.B.
        • Moriarty K.P.
        • Konefal Jr., S.H.
        The Nuss procedure: our experience from the first fifty.
        Pediatr Endosurg Innov Techniques. 2003; 7: 261-266
        • Nezafati P.
        • Shomali A.
        • Kahrom M.
        • Tehrani S.O.
        • Dianatkhah M.
        • Nezafati M.H.
        ZipFix versus conventional sternal closure: one-year follow-up.
        Heart Lung Circ. 2019; 28: 443-449
        • Tam D.Y.
        • Fremes S.E.
        Cable ties for chest closure: ZipFix or ZipFail?.
        J Thorac Cardiovasc Surg. 2018; 156: 1611
        • Koichi O.
        • Yoshiki M.
        • Masanao U.
        • Hiroto Y.
        • Chizuka S.
        • Tatsuo N.
        • et al.
        Comparison of the Nuss procedure for pectus excavatum by age and uncommon complications.
        Osaka City Med J. 2003; 49: 71-76