COMPLEX CHEST WALL DEFORMITY CAUSING CARDIAC ARREST: A PECULIAR PEDIATRIC CASE.

INTRODUCTION

Congenital chest wall deformities are common in children, causing self and parental concern mainly due to cosmesis. These defects rarely cause severe symptoms in patients.

CASE REPORT: 11-year-old girl with a complex chest wall deformity and severe scoliosis causing progressive neurological loss of function. When mobilized to prone position for orthopedic surgery, she suffered sudden hypotension immediately followed by a cardiac arrest, that reverted after moving the child back to supine position. The cardiac arrest was interpreted as a result of a decrease in venous blood return secondary to heart and great vessels compression. She was then proposed and submitted to a modified Ravitch procedure with retrosternal metal bar placement in order to allow ventral positioning. This was successfully achieved, and the patient underwent scoliosis correction 3 months later. After more than a year of follow up, she reduced the need for non-invasive ventilation and tolerates prone positioning.

CONCLUSION

This case report alerts medical community that beyond cosmesis concerns, severe chest wall deformities can cause life-threatening events if not correctly managed.