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Vascular thoracic outlet syndrome developed after minimally invasive repair of pectus excavatum.
[thoracic outlet syndrome]
The
Nuss
procedure
is
a
minimally
invasive
surgical
repair
technique
for
pectus
excavatum
with
fewer
delayed
complications
compared
to
open
procedures
.
We
report
the
case
of
a
22
-
year
-old
man
with
deep
pectus
excavatum
who
developed
vascular
thoracic
outlet
syndrome
after
the
Nuss
procedure
.
Further
evaluation
demonstrated
that
the
first
rib
was
causing
severe
obstruction
of
the
right
subclavian
artery
.
The
patient
showed
clinical
features
of
subclavian
artery
compression
.
A
first
rib
resection
,
division
of
the
anterior
scalene
muscle
and
fibrous
bands
provided
complete
relief
of
the
complaints
.
The
forced
structural
and
spatial
changes
produced
by
the
elevation
of
the
depressed
upper
chest
might
have
caused
this
complication
.
Vascular
thoracic
outlet
syndrome
should
be
kept
in
mind
as
a
possible
complication
in
patients
who
have
undergone
minimally
invasive
repair
of
pectus
excavatum
,
and
this
complication
can
be
treated
by
first
rib
resection
.