Grapow, Martin TRCampelos, PaulaBarriuso, ClementeMulet, Jaume2011-06-082011-06-082011-05-021749-8090https://hdl.handle.net/2445/18330We report about a 37 year old male patient with a pectus excavatum. The patient was in NYHA functional class III. After performed computed tomography the symptoms were thought to be related to the severity of chest deformation. A Ravitch-procedure had been accomplished in a district hospital in 2009. The crack of a metal bar led to a reevaluation 2010, in which surprisingly the presence of an annuloaortic ectasia (root 73 × 74 mm) in direct neighborhood of the formerly implanted metal-bars was diagnosed. Echocardiography revealed a severe aortic valve regurgitation, the left ventricle was massively dilated presenting a reduced ejection fraction of 45%. A marfan syndrome was suspected and the patient underwent a valve sparing aortic root replacement (David procedure) in our institution with an uneventful postoperative course. A review of the literature in combination with discussion of our case suggests the application of stronger recommendations towards preoperative cardiovascular assessment in patients with pectus excavatum.3 p.application/pdfengcc-by, (c) Grapow et al., 2011http://creativecommons.org/licenses/by/2.0/TòraxMalformacionsEstudi de casosChest Human abnormalitiesCase studiesinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccess21535880