K20 -- May 2010 -- Pectus Excavatum
Intro: Pectus excavatum is the most common congenital birth defect. One out of 400 babies is born with a chest wall that doesn't form properly and becomes concave. Kids with pectus routinely have surgery. Adults have either had to live with it or face major, more complicated operations. Now, doctors at Mayo Clinic are performing the same surgery for kids on adults and improving the lives of many people.
"WE'RE DOING A REPAIR OF A DEFORMITY OF THE CHEST WALL CALLED A PECTUS EXCAVATUM."
DR. DAWN JAROSZEWSKI IS A THORACIC SURGEON WHO SPECIALIZES IN PECTUS REPAIR.
"IT WAS ONCE THOUGHT THAT THESE DEFORMITIES WERE ALL COSMETIC AND THEY DIDN'T AFFECT THE PATIENT. NOW WE'RE FINDING THAT PEOPLE CAN HAVE VERY SEVERE HEART AND LUNG PROBLEMS."
"A COUPLE OF YEARS AGO I DEVELOPED A BIT OF A WHEEZING COUGH."
MICHELE KROEGER HAD A MILD CASE OF PECTUS THAT GOT WORSE OVER TIME.
"WHEN I WAS RUNNING IT'D GET HARDER AND HARDER AND I'D BE MORE SHORT OF BREATH. THEN I WAS GETTING MORE PALPITATIONS IN MY HEART. MORE CHEST PAIN."
"YOU CAN SEE HERE THAT THERE'S A VERY NARROW SPACE BETWEEN HER SPINE AND HER CHEST."
THE CONCAVE CHEST WAS COMPRESSING MICHELE'S LUNG AND IT SHIFTED HER HEART TO THE LEFT. TRADITIONAL SURGERY FOR ADULTS MEANS MAJOR SURGERY & OPENING THE CHEST AND REMODELING THE CHEST WALL. BUT DR. JAROWSZEWSKI USES A MUCH LESS INVASIVE TECHNIQUE THAT WAS ONCE ONLY USED FOR CHILDREN. FIRST DR. JAROSZEWSKI MAKES SMALL INCISIONS ON EITHER SIDE OF THE PATIENT. THEN, GUIDED BY A SMALL CAMERA, SHE INSERTS BARS THAT LIFT THE CHEST WALL INTO A MORE NORMAL POSITION.
"THIS IS AN X-RAY WHICH SHOWS AN ADULT WITH TWO BARS AND A NICE REPAIR."
THE BARS ARE SORT OF LIKE BRACES. MICHELE WILL KEEP THEM FOR ABOUT TWO YEARS. WHEN THEY COME OUT, HER CHEST WILL RETAIN ITS NEW SHAPE. NOW SHE CAN CONTINUE HER BUSY LIFE SYMPTOM FREE.
FOR MEDICAL EDGE, I'M VIVIEN WILLIAMS.
Michele says she got relief from symptoms almost immediately after surgery. The only drawback to having the bars in her chest? Michele says she sets off metal detectors in airports, which to her is a small price to pay for a better quality of life. Mayo Clinic is one of only a handful of medical centers in the U.S. performing this operation for adults.
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