Pectus Deformity

Pectus Excavatum
It is a chest wall deformity resulting in a sunken breastbone (sternum) or rib cage.
It occurs in about one in 1,000 people and is more common in males than females.
The deformity may be seen at birth or show up later during childhood or puberty.
It may affect the heart and lungs depending on severity of deformity.
May be associated with other syndromes.

Alternative names of Pectus Excavatum
Funnel breast
Funnel chest
Sunken chest

Medical Help for Funnel Chest
You should see the doctor if you experience the following
Chest pain [compressed heart and lung]
Breathing difficulties [compressed heart and lung]
Decreased exercise tolerance compared to peers [compressed heart and lung]

Evaluation before surgical repair
A complete medical history and physical exam
Chest measurements and photos of the chest
Routine blood investigation
CT scan of chest / Chest X-ray
Pulmonary (lung) function tests (PFT)
Cardiac (heart) echocardiography / ECHO / ECG
To evaluate for effect on the heart, lung and any associated conditions.

Minimally Invasive Repair of Pectus Excavatum [MIRPE]
Use of stainless steel bar
Bone remodels along the bar
No cutting of ribs
Small skin incision
Morphology / Defect based pectus repair

Repair based on morphology and CT images of chest using
TERCOM/ Terrain contour mapping
CT measurement for bar contouring
Park's Morphological classification criteria [symmetrical and asymmetrical defects]
The above techniques help achieve a perfect morphological and heart lung function

Repair of Sunken Chest
The procedure is done under general anesthesia.
Sternal lift technique/Crane technique – Prevent heart, lungs injury.
Pectoscopy – Entire procedure in chest done under endoscopic vision [In thoracoscopy only one side chest under vision]
Specially designed stainless steel bar/ bar stabilizers/ bar fixators / No wire fixation of bars

Complications of MIRPE
If they arise, complications are associated to:
General Anesthesia which is used.
Surgery related
      1. Injury to heart/lung
      2. Pneumothorax/hemothorax
      3. Bar displacement/dislodgement
      4. Wound infection
      5. Care after Pectus/MIRPE Surgery
Postoperation, patient will be shifted to the ICU for monitoring.
Pain control will be our top priority during recovery
Eating will be allowed once patient is awake and able to swallow
Correction of defect will be monitored with Chest x ray / CT thorax.
Chest physiotherapy and postural monitoring during stay which will be continued at discharge
Discharge from hospital usually on the 5th to 7th postoperative day.

Discharge advice
A detailed Dos and Don'ts will be advised according to the age and patient characteristics.
Maintain a good posture
Avoid lifting weight
Avoid contact sports

Bar Removal
Bar removal is done under general anesthesia At the end of 2 years to 3 years depending on age group. It can be done as a day care procedure or overnight admission.

Care after bar removal
Wound care is most important
Keep site clean and dry

Benefits of The Procedure
PHYSIOLOGICAL – Improved heart and lung function
Psychosocial – Improved self esteem
Cosmetic

Important Information
If you are planning for surgery, we can connect you with closed group of patients, who have undergone surgery in past.
For international patients travel, stay and visa assistance provided.