Highlights
- PE is defined as the posterior incursion of the sternum and of the adjacent costal cartilages (Fig 1). In contrast, PC is characterised by the protrusion of the anterior chest wall (View Highlight)
- An objective measure routinely used to gauge the severity of PE is the Haller index (Fig 4). This is obtained from CT imaging by dividing the lateral diameter by the anteroposterior diameter. The condition is considered significant when Haller index is >3.25 (normal value 2.56). (View Highlight)
- Mitral valve prolapse with mitral regurgitation is seen in 18–45% of patients with PE because of mechanical distortion of the mitral annulus (View Highlight)
- The brachial plexus is at particular risk when the arms are abducted during a Nuss repair. (View Highlight)
- The major potential intraoperative complications the anaesthetist needs to be aware of are cardiac, vascular or liver injury or perforation leading to life-threatening haemorrhage. Bar slippage and misplacement can also cause trauma, cardiac compression or right ventricular outflow tract obstruction (View Highlight)