Obliteration of the descending aortic interface in pectus excavatum: correlation with clockwise rotation of the heart.

Abstract

Obliteration of the descending aortic interface is a new radiographic finding in pectus excavatum. Seventy frontal and lateral chest radiographs and 33 computed tomographic (CT) scans of patients with pectus excavatum were retrospectively reviewed to evaluate the frequency, possible cause, and clinical significance of this finding, which was detected in 21 of 70 cases (30%) of pectus excavatum. No significant relationship was found between this finding and the extent of the thoracic deformity. In patients with this finding, the left inferior pulmonary vein (PV) entered the left atrium at an acute angle to the sagittal plane, as demonstrated at CT, and this angle was significantly smaller than that in patients without this finding. The PV angle also significantly correlated with the cardiac rotation angle. In pectus excavatum, partial obliteration of the descending aortic interface can be mistaken for adjacent disease.