case_images: PMC6625957_01
case_images: (
  A
  ) Preoperative severe pectus excavatum; (
  B
  ) displacement of the inferior metal strut; (
  C
  ) the postoperative position of the remaining strut.
case_images: 10-1055-s-0039-1692195-i180416cr-1.jpg
case_images: PMC6625957_01_10-1055-s-0039-1692195-i180416cr-1.jpg
case_images: FI180416cr-1
case_images: The superior vena cava (SVC) pathway was clear, but the inferior vena cava (IVC) system was partially occluded with two long plaques below the cavoatrial junction ( Fig. 1 ). 
case_images: (
  A
  ) Lower limb angiography showing partial occlusion of both femoral arteries and absent circulation in the popliteal arteries; (
  B
  ) the lateral X-ray of the remaining strut.
case_images: 10-1055-s-0039-1692195-i180416cr-2.jpg
case_images: PMC6625957_01_10-1055-s-0039-1692195-i180416cr-2.jpg
case_images: FI180416cr-2
case_images: An indication for urgent cardiac operation and strut removal was quoted to the parents with high intraoperative risks ( Fig. 2 ). 
case_images: (
  A
  ) Intracardial metal strut ending its course in the left ventricle "muffed" by thrombus; (
  B
  ) iatrogenic ventricular septal defect after strut and thrombus removal.
case_images: 10-1055-s-0039-1692195-i180416cr-3.jpg
case_images: PMC6625957_01_10-1055-s-0039-1692195-i180416cr-3.jpg
case_images: FI180416cr-3
case_images: After the cardiac arrest, the strut was removed without resistance ( Figs. 3 and 4 ). 
case_images: Intraoperative moment of metal strut removal.
case_images: 10-1055-s-0039-1692195-i180416cr-4.jpg
case_images: PMC6625957_01_10-1055-s-0039-1692195-i180416cr-4.jpg
case_images: FI180416cr-4
case_images: After the cardiac arrest, the strut was removed without resistance ( Figs. 3 and 4 ). 
case_images: VSD closed with a PTFE patch with repair of the RV wall. PTFE, polytetrafluoroethylene; RV, right ventricular; VSD, ventricular septal defect.
case_images: 10-1055-s-0039-1692195-i180416cr-5.jpg
case_images: PMC6625957_01_10-1055-s-0039-1692195-i180416cr-5.jpg
case_images: FI180416cr-5
case_images: The VSD was closed with a 0.6 mm polytetrafluoroethylene (PTFE) patch and the cardiac apex reconstructed with direct pledgeted sutures ( Fig. 5 ). 