Correct “Sunken Chest” With Minimal Invasive Surgery

Correct “Sunken Chest” With Minimal Invasive Surgery

Sunken Chest Pectus Excavatum is the most common chest wall deformity that causes the breastbone and several ribs to grow abnormally, giving the chest a “caved-in” or “Sunken” appearance. It can be present at birth. However, most of patients notice the dormifity at teenage and may grow more sunken over time.

For normal daily activities, there is no impact on heart or lung function but it can compromise lung and heart capacity, causing the patient to experience shortness of breath because lungs are confined and cannot properly expand.

Types of Deformities:

1. Cup Deformity: a narrow depression on the chest.
2. Saucer Deformity: a wide and flat depression on the chest.
3. Grand Canyon Deformity: the deepest depression on the chest.

What is The Cause & Who is at RisK

Up to these days, the cause of Pectus Excavatum is unknown, but it is found out that approximately 20% of the patients have family members with the defect. It is a relatively common congenital deformity and occurs 3-4 times more frequently in males than in females. Moreover, Pectus Excavatum is commonly associated with connective tissue disorders such as Marfan and Ehlers Danlos syndromes.

Signs and Symptoms of Pectus Excavatum

• There may be symptoms of chest pain.
• Sunken appearance of the breastbone.
• 30% of patients diagnosed with abnormal heart sounds are caused by heart valve condition.
• It may also be associated with scoliosis.
• Mitral valve prolapse.
• Collapsed lung.

Treatment Approaches for Pectus Excavatum

1. Ravitch Procedure: a traditional surgical treatment for pectus excavatum wherein a cut is made across the chest and a metal bar is placed under the breastbone to maintain the newly formed shape. Second operation will be required 6 months later for bar removal.
2. Sternal Turnover: requires an open cut to remove the breastbone with costal cartilages, then turning over and fix it in the correct position.
3. Minimally Invasive Repair of Pectus Excavatum (MIRPE): performed by the use of thoracoscopy and it does not require cartilage resection and leaves very tiny scars. The bar will be kept in place for 4 years before ot needs to be removed.

Another chest deformity in the same category is called “Pectus Carinatum”, which is characterized by a protrusion of the chest and ribs. It occurs less frequently than Pectus Excavatum.

The standard treatment approach for Pectus Carinatum is orthotic bracing. The brace will apply a pressure on the affected area to flatten the chest.