More Adults Opt to Repair Chest Defect

Surgical Fix For "Sunken Chest" Now Safer, Easier

From the WebMD Archives

Sept. 30, 2002 -- Thanks to advances in surgical techniques, more people born with common congenital chest deformities can now safely get their condition fixed as adults and live more active lives.

A new study found a growing number of people born with a "sunken" or "concave" chest, a condition known as pectus excavatum (PE), can find relief through corrective surgery as adults. In the past, most adults were told that surgery to correct their deformity would be too messy and unnecessary.

PE is the most common major congenital chest deformity and happens in about one of every 400 births. The condition usually becomes apparent during the first year of life and the depression in the chest usually becomes more severe during adolescence.

Another type of common chest defect, known as pectus carinstum (PC), in which the chest cavity pushes outward, often goes unnoticed until adolescence.

Both of these defects remain with the same degree of severity throughout adulthood. But researchers say many patients report that symptoms, such as chest pain, difficulty breathing, and loss of energy or stamina during exercise, get worse as they grow older.

The study looked at the medical records of all the adult patients who had their PE or PC deformity corrected at the UCLA Medical Center from January 1969 to December 2001. During this time, 545 people had their PE defect corrected, and 99 patients underwent repair for their PC deformity.

In the last 15 years, 116 of the patients were 19 years or older, and 106 of these patients had the surgery within the past 6 years.

Of the 113 adults interviewed, 97% said they considered the results of their corrective surgery very good or excellent and that they would recommend it to other people with the deformities. All but three of the patients interviewed said they experienced a moderate to marked improvement in exercise tolerance with less shortness of breath and increased stamina and endurance.

"More than ever, we are seeing adults who never received treatment during their childhood, usually because they were told that surgical repair was dangerous and minimally effective," says researcher Eric Fonkalsrud, MD, professor of surgery at UCLA, in a news release.

But Fonkalsrud says that in the last five years new minimally invasive techniques and the increased availability of information about PE on the Internet have made more patients of all ages aware that their deformities can be corrected successfully.

The study appears in the September issue of Annals of Surgery. -->

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