Staged approach to combined repair of pectus excavatum and lesions of the heart

The combined repair of severe pectus excavatum and cardiac lesions remains technically difficult. We report our experience with a patient undergoing such a combined repair of pectus and implantation of an aortic valved conduit in the setting of the Marfan syndrome. The procedure was staged such that the dissection and bony mobilization was done at the first procedure before heparin administration in combination with a sternal split and subsequent aortic repair. The second stage of sternal repositioning and cartilage resection was completed several days later with excellent cardiopulmonary and cosmetic results. The technique and a review of the literature are included.