Journal of Surgery
Research Article
The Utility of Screening Echocardiograms in Congenital Chest Wall Deformities
Gershner GH, He D, Pardue K, Stewart K, Cave A and Hunter CJ
1The University of Oklahoma Health Sciences Center, Department of Surgery, 800 Research Parkway, Suite 449, Oklahoma City,
2Division of Pediatric Surgery, Oklahoma Children’s Hospital, 1200 Everett Drive, ET NP 2320 Oklahoma City
3Division of Pediatric Cardiology, Oklahoma Children’s Hospital, 1200 Everett Drive, ET NP 2320 Oklahoma City
2Division of Pediatric Surgery, Oklahoma Children’s Hospital, 1200 Everett Drive, ET NP 2320 Oklahoma City
3Division of Pediatric Cardiology, Oklahoma Children’s Hospital, 1200 Everett Drive, ET NP 2320 Oklahoma City
*Address for Correspondence: Catherine J. Hunter, Department of Pediatric Surgery, Oklahoma Children’s Hospital, Oklahoma City. E-mail Id: catherine-hunter@ouhsc.edu
Submission: 30 September, 2025
Accepted: 24 October, 2025
Published: 28 October, 2025
Copyright: © 2025 Gershner GH, et al. This is an open access article
distributed under the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
Keywords: Congenital chest wall deformities; connective tissue
disease; echocardiograms; screening tests; pectus excavatum;
pectus carinatum
Abstract
Objective: Congenital chest wall deformities (CCWD) are bony
or cartilaginous defects of the chest. These deformities result in both
an abnormal appearance and, in many cases, cardiopulmonary
compromise. Evidence is growing regarding the cardiovascular
implications of CCWD. Screening echocardiograms (ECHOs) are
increasingly utilized for patients with chest wall deformities to assess
cardiac function. We sought to describe the impact of screening
ECHOs on patients with CCWD.
Methods: This is a retrospective study. Using ICD10 diagnosis codes, a cohort was generated. Manual chart review performed for demographic data, CCWD diagnosis, and ECHO reports. Additional chart review was performed to see if patients were seen by Pediatric Cardiology, and what the documented plan was including potential intervention. Results: We found 494 patients that fit inclusion criteria. Patients with CCWD most often had pectus excavatum or pectus carinatum. The most common ECHO findings included mitral valve prolapse, patent foramen ovale, and aortic root dilation. Most patients did not require cardiology follow up (86%), with even less requiring cardiologic interventions (1%). We found 10 patients with connective tissue disease.
Conclusions: Patients with CCWD benefit from screening ECHOs in order to find cardiac anomalies that could impact pre, intra, and post-operative management. Findings could also initiate the workup for CTD and Cardiology involvement, further improving patient care.
Methods: This is a retrospective study. Using ICD10 diagnosis codes, a cohort was generated. Manual chart review performed for demographic data, CCWD diagnosis, and ECHO reports. Additional chart review was performed to see if patients were seen by Pediatric Cardiology, and what the documented plan was including potential intervention. Results: We found 494 patients that fit inclusion criteria. Patients with CCWD most often had pectus excavatum or pectus carinatum. The most common ECHO findings included mitral valve prolapse, patent foramen ovale, and aortic root dilation. Most patients did not require cardiology follow up (86%), with even less requiring cardiologic interventions (1%). We found 10 patients with connective tissue disease.
Conclusions: Patients with CCWD benefit from screening ECHOs in order to find cardiac anomalies that could impact pre, intra, and post-operative management. Findings could also initiate the workup for CTD and Cardiology involvement, further improving patient care.
Glossary of Abbreviations:
1. Congenital chest wall deformities - CCWD2. Pectus Excavatum - PE
3. Pectus Carinatum - PC
4. Pectus Arcuatum - PA
5. Poland Syndrome - PS
6. Connective Tissue Disorder - CTD
7. Echocardiogram - ECHO
8. Left ventricle ejection fraction - LVEF
9. Mitral valve prolapse - MVP
10. Patent foramen ovale - PFO
11. Aortic root dilation - ARD
12. Marfan’s Syndrome - MFS
13. Ehlers-Danlos Syndrome - EDS
14. Loeys-Dietz Syndrome - LDS
15. Mixed Connective Tissue Disease - MCTD
16. Anterior-to-Posterior - AP
17. Right ventricle - RV
18. Ventricular premature complexes - VPC