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Congenital birth defect to be studied as to impact on heart and lungs

Mayo Clinic investigating whether surgery to correct pectus affects breathing

Friday, October 19, 2007

SCOTTSDALE, Ariz. — Pectus, a congenital chest deformity resulting in either a protruding or concave chest, is not only cosmetically unappealing, but can potentially have serious physical limitations affecting the heart and lungs.

Mayo Clinic is currently investigating whether surgery to correct pectus can impact the heart and lung functions caused by pectus excavatum (a concave chest) or pectus carinatum (a protruding chest), two very common congenital birth defects affecting one in 400 children. In some cases, the deformities can cause physical limitations, chest discomfort and breathing problems.

Pectus excavatum (PE), in which the breastbone is depressed, creates a diminished space in the chest cavity for lungs to expand, making it difficult to breathe. Pectus carinatum (PC) is characterized by a protruding breastbone, which makes it difficult to completely exhale air in the lungs, causing short, rapid breathing and reduced exercise endurance. Surgery to correct either form of this deformity can be safely performed with few complications and a short hospital stay.

Despite numerous published reports in small groups of patients, there is no consensus on what degree of physiological abnormality, if any, exists with pectus deformity. Also, convincing evidence of physiological improvement following surgical repair of the condition is lacking. Many patients, however, report improvement in exercise tolerance, reduction in chest discomfort and less palpitations following surgical repair.

As part of the study, patients will undergo a cardiopulmonary stress test before surgical correction. This test will define any cardiopulmonary abnormalities present before surgery. The study will also include a multi-purpose health survey that will provide a profile of functional health and well-being scores, plus physical and mental scores.

Improvements in respiratory mechanics, cardiac function and exercise performance will be identified by repeating the measurements six months following corrective surgery.

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