You can see here this very narrow space between her spine here and her chest. And then I was getting more palpitations in my heart, chest pain. When I'd be running, it'd be harder and harder. Michelle Kroeger had a mild case of pectus that got worse over time. And now, we're finding out that people can have very severe heart and lung problems.Ī couple of years ago, I developed a little bit of a wheezey cough. It was once thought that these deformities were all cosmetic and it didn't affect the patient at all. Dawn Jaroszewski is a thoracic surgeon, who specializes in pectus repair. We're doing a repair of a deformity of the chest wall, called a pectus excavatum.ĭr. Now, doctors at Mayo Clinic are performing the same surgery for kids on adults and improving the lives of many people. Adults have either had to live with it or face major more complicated operations. One out of 400 babies is born with a chest wall that doesn't form properly and becomes concave. Pectus excavatum is the most common congenital birth defect. Used for 20 to 30 minutes daily, this is a potential treatment to prevent the worsening of pectus in children as they grow. The FDA has recently approved the use of suction cups to help raise the depressed breastbone in younger patients developing pectus. Cryoablation temporarily freezes the nerves to block pain after surgery and can help with recovery and decrease postoperative pain for 4 to 6 weeks. There are many options for pain control after surgery to help improve recovery. Although most surgeries for pectus excavatum are performed around the growth spurt at puberty, many adults also have benefitted from pectus excavatum repair. Most people who undergo surgery to correct pectus excavatum are happy with the change in how their chests look, no matter which procedure is used. These supports are removed after 12 months. The surgeon removes the deformed cartilage attaching the ribs to the lower breastbone and then fixes the breastbone into a more normal position with surgical hardware, such as a metal strut or mesh supports. This older procedure involves a much larger incision down the center of the chest. The bars are removed after two or three years. In some cases, more than one bar is used. A curved metal bar is threaded under the depressed breastbone, to raise it into a more normal position. Long-handled tools and a narrow fiber-optic camera are inserted through the incisions. This minimally invasive procedure uses small incisions placed on each side of the chest. The two most common surgical procedures to repair pectus excavatum are known by the names of the surgeons who first developed them: The bar is then flipped over to create an arch that presses upward on the breastbone. The Nuss procedure inserts a curved metal bar through small incisions on each side of the chest. This test monitors how well your heart and lungs function while you exercise, usually on a bike or treadmill. These types of tests measure the amount of air your lungs can hold and how quickly you can empty your lungs. An echocardiogram also gives your doctor a look at how the chest wall may be affecting heart function and the flow of blood through the heart. The images are produced by transmitting sound waves via a wand pressed against the chest. It can show real-time images of how well the heart and its valves are working. An echocardiogram is a sonogram of the heart. This test is painless and involves the placement of more than a dozen electrical leads, which are attached to the body with a sticky adhesive. An electrocardiogram can show whether the heart's rhythm is normal or irregular, and if the electrical signals that control the heartbeat are timed properly. CT scans and MRIs take many images from a variety of angles to produce cross-sectional images of the body's internal structure. These tests may be used to help determine the severity of the pectus excavatum and whether the heart or lungs are being compressed. X-rays are painless and take only a few minutes to complete. This test can visualize the dip in the breastbone and often shows the heart being displaced into the left side of the chest. Your doctor may suggest several different types of tests to check for associated problems with the heart and lungs. Pectus excavatum can usually be diagnosed simply by examining the chest.
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