Friday, May 21, 2010
PHOENIX — A 20-year-old medical student from Peru who came to Phoenix for medical care underwent surgery at Mayo Clinic Hospital on Tuesday, May 18, for a devastating medical condition called pectus excavatum.
Pectus excavatum, often referred to as "sunken chest," is a deformity of the chest wall that, left untreated, can cause serious breathing and cardiac issues, especially as patients age.
The patient, from Piura, Peru, is a first-year medical student and first in his class at the state school there. Through a family friend in Peru, he connected with pediatric surgeon Leigh McGill, M.D. who was in Peru for a medical mission to treat children who otherwise would not have access to specialty care. Dr. McGill, past chair of the Department of Surgery at Phoenix Children's hospital, then contacted Mayo Clinic cardiothoracic surgeon, Dawn Jaroszewski, M.D., who specializes in surgery for pectus and other chest wall deformities. Dr. Jaroszewski agreed to evaluate the young patient for surgery to correct his deformity.
The surgery was performed in Phoenix because of a unique program between Mayo Clinic and Phoenix Children's Hospital, where surgeons from both medical centers combine their expertise in pectus surgery for both adults and children.
Through an interpreter, the patient said that his condition, which has grown progressively worse over time, has prevented him from participating in activities such as football and running, and that he experiences significant fatigue, shortness of breath and heart palpitations. In his case, the pectus deformity had pushed his heart far into the left chest and was crushing the right side of the heart.
The patient also revealed that the condition has caused him psychological issues, not only because of his medical problems, but because of the ridicule that he faced as a child and teenager growing up having "a chest that was not normal". "My son is very sad," confirmed his father, who accompanied him from Peru to Phoenix. "His favorite hero is Superman because he wants to someday have a chest like him," the father added.
When asked about his plans after completion of medical school, the patient, one of six children in his family, expressed that he wants to be a surgeon — and to perform complex chest surgery like he is experiencing.
The three-hour surgery was completed by Dr. Jaroszewski from Mayo Clinic and Dr. Lisa McMahon, pediatric surgeon from Phoenix Children's Hospital. To repair pectus excavatum, the surgeons perform a minimally invasive procedure where small incisions are made on each side of the chest, and a stainless steel bar, guided by a small video camera, is placed through the incisions to push the chest outward. The bars remain in place for two to three years and are then removed.
This procedure is markedly different from the old, open chest procedure, where a front incision, deep through the chest muscle down to the bones, was made. The ribs were cut shorter and the breastbone was moved, with everything wired back in the proper place afterwards.
The patient was doing well following surgery and is expected to be hospitalized for four to five days and then will return to Peru. He was excited and happy with his new "normal" chest, and calls himself "Super Henry". Within a few months, he should be able to start running and playing all the sports and activities he has been prevented from participating in because of his deformity. His heart and lungs are expected to be normal now without any long-term lasting effects from the years of being crushed by his previously sunken chest.
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