61. Funnel Chest (pectus Excavatum) Definition - Medical Dictionary Definitions Of P Online Medical Dictionary and glossary with medical definitions. http://www.medterms.com/script/main/art.asp?articlekey=3530

62. ARTICLE: Pectus Excavatum Diagnosis And Treatment pectus excavatum is a chest wall abnormality where the sternum (breast bone) and ribs are depressed inwards (concave) giving the appearance of a sunken http://www.wecare4lungs.com/pe.htm

HOME SITE CONTENTS SEARCH SITE CONTACT US ARTICLES AND RESOURCES Articles of Interest Exercise-Induced Asthma Cystic Fibrosis and Exercise Pectus Excavatum ... Scholarly Productivity - CV DID YOU KNOW? Pectus Excavatum occurs in approximately 1 to 8 out of 1000 people. For reasons that are unknown, it occurs much more frequently in boys than in girls! DID YOU KNOW? Another type of “pectus” deformity is called a Pectus Carinatum is a condition where the breast bone protrudes outward and is often called “pigeon chest” because of the resemblance of the chest wall of a pigeon. This condition usually has little consequence. PECTUS EXCAVATUM Our center offers a unique comprehensive program for the child with Pectus Excavatum deformity. Through an extensive evaluation, we can assist in determining the severity of the Pectus deformity from visual, radiographic, psychologic, and physiologic perspective. Based on the evaluation, appropriate surgical and non surgical treatment options will be addressed. Diagnosis - Surgery - Non Surgical Approaches What is Pectus Excavatum?

63. Pectus Excavatum - Washington DC pectus excavatum Washington Hospital Center is located in Washington DC. http://www.whcenter.org/12343.cfm

cddcodebase = "navtools/topmenu/";cddcodebase367050 = "navtools/topmenu/"; Article Manager Home Health Information Encyclopedia - Symptoms Back to Health Library Print This Page Email to a Friend Pectus excavatum ... Pectus excavatum repair - series Pectus excavatum Definition: Pectus excavatum is the descriptive term for an abnormal formation of the rib cage, in which the distance from the breastbone (sternum) to the backbone (vertebrae) is decreased, giving the chest a caved-in or sunken appearance. Alternative Names: Funnel chest Considerations: Pectus excavatum is a congenital abnormality that can be mild or severe. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep. It is caused by excessive growth of the costosternal cartilage (the connective tissue joining the ribs to the breastbone), which causes an inward deformity of the sternum. If pectus excavatum is severe, it may affect the heart and lungs, making exercise difficult. Also, the appearance of the chest may cause psychological difficulty for the child. Pectus excavatum may occur as the only abnormality, or in association with other syndromes.

64. Pectus Excavatum pectus excavatum. pectus excavatum is a condition in which the breast bone (sternum) appears sunken and the chest concave. It is sometimes called funnel http://www.lifespan.org/ADAM/English/Images/2927.htm

Careers at Lifespan Volunteer your time Other ways to give Lifespan's A - Z Health Information Library Pectus excavatum is a condition in which the "breast bone" (sternum) appears sunken and the chest concave. It is sometimes called "funnel chest". The majority of these cases are not associated with any other condition (isolated findings). However, some syndromes include pectus excavatum. Review Date: 1/17/2004 12:00:00 AM Reviewed By: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited. Home Search News Find a Physician ... Site Map Web site design by Lifespan By using this website, you accept the terms of our user agreement . Please read it.

65. Pectus Excavatum of the operationThe repair of pectus excavatum has changed over the......Repair of pectus excavatum may be recommended for improved appearance http://www.pediatricsurgeons.com/pectus.html

Other names: funnel chest or sunken chest. Indications: Repair of pectus excavatum may be recommended for: improved appearance (cosmetic repair), improved breathing (respiratory function), or to stop compression of the heart. Description of the operation: The repair of pectus excavatum has changed over the past several years. We now use the minimally invasive Nuss procedure. The old procedure required a large incision on the front of the chest and removal of 6-8 sets of cartilage. The much less invasive Nuss procedure is described here: While the child is deep asleep and pain-free (using general anesthesia), 2 small incisions are made over the sides of the chest and a curved titanium bar is passed behind the breastbone (sternum). The deformed sternum is elevated when the curved bar is turned over. The placement of the bar may be aided by the use of a small scope placed into the chest to monitor the bars progress. Once the bar is in place it is sutured under the muscle so it will not move. Rarely a chest tube may be placed to reexpand the lung if the lining of the lung is entered. Expectations after surgery: The child will have some pain after the procedure but this will be controlled with either an epidural catheter or a PCA (patient controlled analgesia) pump. The child is usually in the hospital 3 to 4 days after the surgery. The metal bar is removed 2-3 years later through a small skin incision. This removal is usually done as an outpatient. After the repair the child will be on restricted activity for a time period and will gradually return to full activity.

66. Vesalius Image Archive: Nuss Procedure For Pectus Excavatum Nuss Procedure for pectus excavatum Images. Support UNICEF. Pectus index. VID 610, frame 2 nusG3011. Markings. VID 610, frame 3 nusP3012. Templates. http://www.vesalius.com/graphics/archive/archtn.asp?VID=611&nrVID=610

67. Concave Chest (pectus Excavatum) - OhioHealth pectus excavatum is an abnormality of the rib cage, resulting in a cavedin appearance of the chest. It s typically not a serious problem. http://www.ohiohealth.com/healthreference/reference/0E8348DE-4C1E-4658-B534E7BD8

68. Dr. Jillian Roberts > Nuss Pectus Excavatum Preliminary Findings Children Who Have Undergone the Nuss pectus excavatum Procedure. Purpose of Study Surgical Correction of pectus excavatum The Munster experience. http://www.educ.uvic.ca/faculty/jjrobert/research/npe.htm

Home Research Nuss Pectus Excavatum Congenital Heart Disease ... Contact PRELIMINARY FINDINGS Children Who Have Undergone the Nuss Pectus Excavatum Procedure Purpose of Study To better understand the quality of life experiences of children who have undergone the Nuss Pectus Excavatum Procedure. To develop a more comprehensive foundation of knowledge allowing medical and school professionals to better care for these children. Specific Project Aims To better understand what life is like for these children after the surgical procedure. To identify changes in quality of life from the perspective of the children. To identify changes in quality of life from the perspective of the parents. What is Pectus Excavatum? Nuss Pectus Excavatum Procedure new window to view detailed photos of the Nuss procedure. Pop up a new window to view photos of other procedures.

69. Pectus Excavatum What effect does pectus excavatum have on the heart and lungs? The symptoms of pectus excavatum generally fall into three categories 1. Pain. http://www.cardiothoracicsurgery.wustl.edu/PatientCare/PectusExcavatum.asp

Pediatric Cardiothoracic Surgery Heart Transplant Lung Transplant Pectus Excavatum ... Washington University Physicians Pectus Excavatum What is pectus excavatum? What causes pectus excavatum? The cause is unknown, although most children with the condition have had it since birth or early infancy. It may occur as a result of uncoordinated growth between the ribs and the chest. If the ribs grow faster than the expansion of the heart and lungs (which push the sternum outward) then the sternum will be pushed inward. Once this has occurred, the deformity either persists or gets worse. What effect does pectus excavatum have on the heart and lungs? For normal day-to-day activities, there is no impact on heart or lung function. Most children will have a lung capacity slightly below average but still within what is considered the normal range. However, the ability of the heart to pump effectively during strenuous exercise may not be normal. Several medical studies have indicated that the sternum may press on the heart enough that the heart cannot fill with blood and pump it out as rapidly as with a normal chest. These same studies demonstrate that the pumping ability of the heart is improved following surgical repair of pectus excavatum. However, there generally is no change in lung capacity following repair.

70. Pectus Excavatum - Information & News Children and teenagers who suffer from a condition called funnel chest, or pectus excavatum, in which the chest wall becomes cavedin, now have a safe, http://www.news-medical.net/?keyword=Pectus excavatum

71. New Technique To Treat Condition Called Funnel Chest, Or Pectus Excavatum ? Children and teenagers who suffer from a condition called funnel chest, or pectus excavatum, in which the chest wall becomes cavedin, now have a safe, http://www.news-medical.net/?id=5252

72. Pectus Excavatum And Poland's Syndrome: Surgical Correction The above policy is based on the following references. pectus excavatum Correction of pectus excavatum and pectus carinatum assisted by the endoscope. http://www.aetna.com/cpb/data/CPBA0272.html

Document Utilities Home Clinical Policy Bulletins Medical Clinical Policy Bulletins Number: (Updated) Subject: Pectus Excavatum and Poland's Syndrome: Surgical Correction Reviewed: June 07, 2005 Important Note Each benefit plan defines which services are covered, which are excluded, and which are subject to dollar caps or other limits. Members and their providers will need to consult the member's benefit plan to determine if there are any exclusions or other benefit limitations applicable to this service or supply. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered (i.e., will be paid for by Aetna) for a particular member. The member's benefit plan determines coverage. Some plans exclude coverage for services or supplies that Aetna considers medically necessary. If there is a discrepancy between this policy and a member's plan of benefits, the benefits plan will govern. In addition, coverage may be mandated by applicable legal requirements of a State, the Federal government or CMS for Medicare and Medicaid members. CMS's Coverage Issues Manual can be found on the following website: http://cms.hhs.gov/manuals/pub06pdf/pub06pdf.asp

73. Nemours.org - Pectus Excavatum - Case Study pectus excavatum Case Study. Ryan was born with pectus excavatum, or sunken chest, a congenital defect that can cause shortness of breath and http://www.nemours.org/internet?url=no/cases/pectus.html

74. Medical Policy | SURGICAL TREATMENT OF PECTUS EXCAVATUM SURGICAL TREATMENT OF pectus excavatum. Shamberger RC, Welch KJ. Cardiopulmonary function in pectus excavatum. Surg Gynecol Obstet 1988; 16638391. http://medpolicy.bluecrossca.com/policies/surgery/pectus_excavatum.html

Medical Policy SURGICAL TREATMENT OF PECTUS EXCAVATUM Section: Surgery Initial Review: Subsection: General Latest Review: Publishing Date: Description: Pectus excavatum, in which the sternum is displaced posteriorally to produce a funnel shaped depression, is the most common congenital deformity of the chest wall, occurring in as many as 1 to 300 live births.  The degree of sternal depression is assessed on a CT scan or lateral chest x-ray by measuring either the sternovertebral distance or a ratio of sternovertebral distance to transthoracic diameter.  The etiology is not precisely understood, but overgrowth of the lower costal cartilages and ribs is thought to be responsible.  Correction of pectus excavatum is usually performed to restore normal appearance, although some patients may have associated medical complications, such as recurrent respiratory infections, pneumonia, asthma, cardiac arrhythmias, atypical chest pain or exercise intolerance.  Work-up may include pulmonary function tests, CT scans to evaluate displacement of the heart and echocardiography to evaluate cardiac hemodynamics. Until recently surgical correction of pectus excavatum involved the resection of the involved costal cartilages and osteotomy of the sternum with placement of a metal bar behind the sternum.  The metal bar may be removed in one to two years. In the past several years, a minimally invasive approach has been developed that involves the placement of a convex steel bar beneath the sternum through small bilateral thoracic incisions.  The bar may be removed after two years when remolding of the cartilage is complete.  This procedure, which may be referred to as the Nuss procedure or MIRPE (minimally invasive repair of pectus excavatum), does not require cartilage resection or sternal osteotomy.

75. Pectus Excavatum I\ m wondering if anyone has heard of pectus excavatum (sunken chest) being reversed with Re pectus excavatum, Chris Maloney, 0, 02/28/04 1149 PM http://www.pandamedicine.com/rt_children/78.html

Naturopathic Medicine Naturopathic Physicians Naturopathic Education Find a Doctor ... Sponsor Us Health Corner Detox, lose weight, feel better! All with one professionally formulated 4-week program. Stay Updated Pectus Excavatum Posted by Cheryl on 02/14/04 at 07:24 AM Read Replies Reply to This Post Return to RoundTable Replies Posted By Re: Pectus Excavatum Dr. Leonard M.D. 07:09 PM Re: Pectus Excavatum onur 01:33 PM Re: Pectus Excavatum Chris Maloney 11:49 PM Submit Your Reply Your Name Your Email Topic Message

76. Pectus Excavatum Repair pectus excavatum is a deformity of the front of the chest wall with depression of the breastbone Repair of pectus excavatum may be recommended for http://www.shands.org/health/surgeries/100035.html

Pectus excavatum repair Normal anatomy Pectus excavatum is a deformity of the front of the chest wall with depression of the breastbone (sternum) and rib (costal) cartilages Review Date: 06/25/01 Reviewed By: A.D.A.M. Medical Illustration Team Indications Repair of pectus excavatum may be recommended for: improved appearance (cosmetic repair) improved breathing (respiratory function) Review Date: 06/25/01 Reviewed By: A.D.A.M. Medical Illustration Team Procedure While the child is deep asleep and pain-free (using general anesthesia), an incision is made over the breastbone (sternum). The deformed cartilage are removed and the rib lining is left in place to allow re-growth of the cartilage. An incision is made in the sternum and it is repositioned. A rib or metal strut may be used to stabilize the sternum in normal position until healing occurs in 3 to 6 months. A chest tube may be placed to re-expand the lung if the lining of the lung is entered. Metal struts are removed 6 months later through a small skin incision under the arm. This procedure is usually done as an outpatient. Review Date: 06/25/01 Reviewed By: A.D.A.M. Medical Illustration Team

77. Pectus Excavatum pectus excavatum is a congenital abnormality that can be mild or fairly marked. If pectus excavatum is severe, it may affect the underlying organs http://www.shands.org/health/information/article/003320.htm

Disease Injury Nutrition Poison ... Pectus excavatum repair - series Pectus excavatum Definition: The descriptive term for an abnormal formation of the rib cage where the distance from the breastbone (sternum) to the backbone (vertebrae) is decreased, resulting in a caved-in or sunken chest appearance. Alternative Names: Funnel chest Considerations: Pectus excavatum is a congenital abnormality that can be mild or fairly marked. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep. It is caused by excessive growth of the costosternal cartilage (the connective tissue joining the ribs to the breastbone), with resulting inward deformity of the sternum. If pectus excavatum is severe, it may affect the underlying organs (heart and lungs) leading to exercise intolerance or other problems. In addition, the cosmetic appearance of a pectus excavatum may pose a psychological difficulty. Pectus excavatum may occur as the only abnormality, or in association with other syndromes. Common Causes: Isolated defect (i.e., not associated with other problems)

78. Pectus Excavatum Question Patient medical question and answer from The Family Practice Forum. Health topic area and articles about bones Topics pectus excavatum,cosmetic, heart, http://www.medhelp.org/forums/FamilyPractice/messages/326.html

Questions in the Family Practice Forum have been answered by Kevin Pho, M.D.. Dr. Pho specializes in medical information research and medical text review and editing. Pectus Excavatum Question Forum: The Family Practice Forum Topic: Bones Subject: Pectus Excavatum Question From To Post Hi, I am a 27 year old male and have a cosmetic case of pectus excavatum. It is mild, but I notice it when I turn sideways and look in the mirror. I play sports and work out on a regular basis, so I don't think it affects my lung capacity. When doctors have seen me with my shirt off, they haven't mentioned anything about it. I do get self-conscious about it sometimes in dating, etc. Most women don't see it because I wear a shirt most of the time, but when I go to the beach that's when it becomes noticeable. Since it's cosmetic, should I still get it fixed? Just the thought of repositioning my sternum at my age is scary because I know my bones are in their fully grown state. Thanks for your help. Forum-M.D.-KP

79. Pectus Excavatum Patient medical question and answer from The Heart Forum. Health topic area and articles about arrhythmia Topics ,bradycardia, seizures, atrial, potential, http://www.medhelp.org/forums/cardio/messages/34285.html

Questions in The Heart Forum are being answered by doctors from The Cleveland Clinic Heart Center, consistently ranked the #1 Heart Center in America. Pectus Excavatum Forum: The Heart Forum Topic: Arrhythmia Subject: Pectus Excavatum From To Post Erich My father is a 74 year old white male with a 35 year history of self-resolving atrial fibrillation 2-4 times per year with 12-24 hour duration. Occasionally the atrial fib was associated with severe bradycardia, with absence of heartbeat for 10-20 seconds. The bradycardia was not diagnosed until 10 years ago. Previously he was misdiagnosed as having epilepsy. Finally, after suffering repetative "seizures" he went to the emergency room where an EKG monitor recorded the source of his "seizures." His heart was stopping! A single lead vetricular pacemaker was then implanted to control the severe bradycardia. My father does not faint or have seizures anymore, but he still has episodes where he feels like he is going to faint. It starts out with a startling feeling, then he gets tingling in his arms and legs/feet. He gets a weird psychological feeling (impending doom). After about a minute, during which time (if he is sitting or standing) he lays down wherever he is, this completely resolves itself and he feels just fine. These episodes happen in groups of five or ten over a couple days, every few months. They are not associated with exertion and also happen during sleep (it wakes him up). My father is otherwise in excellent health. He does, however, have pectus excavatum. None of his doctors have ever noted this as a potential cause of his arrhythmias and syncopal episodes. At his age, what are the risks of corrective surgery for the pectus excavatum? I ask this because it isn't worth his time to examine this potential cause if he the cure is not recommended.

80. EPIDURAL ANALGESIA VS. INTRAVENOUS OPIOIDS AFTER PECTUS EXCAVATUM REPAIR -- Rama INTRAVENOUS OPIOIDS AFTER pectus excavatum REPAIR. Rangamani K. Raman, FRCA , Nao Nakatsuka, BSc , Carolyne J. Montgomery, FRCPC , Erik D. Skarsgard, http://www.cja-jca.org/cgi/content/full/51/suppl_1/A93

HOME HELP FEEDBACK SUBSCRIPTIONS ... TABLE OF CONTENTS This Article Full Text (PDF) Submit a response Alert me when this article is cited ... Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager PubMed Articles by Raman, R. K. Articles by Court, C. A. Canadian Journal of Anesthesia Canadian Anesthesiologists' Society Abstracts - Tuesday June 22nd 2004 1030-1230 EPIDURAL ANALGESIA VS. INTRAVENOUS OPIOIDS AFTER PECTUS EXCAVATUM REPAIR Rangamani K. Raman, FRCA Nao Nakatsuka, BSc Carolyne J. Montgomery, FRCPC Erik D. Skarsgard, FRCSC and Colleen A. Court, RN INTRODUCTION The pain management techniques for the Ravitch repair of pectus excavatum are intravenous opioid analgesia (IOA), including patient-controlled analgesia (PCA) and continuous opioid infusion (COI), and thoracic epidural analgesia (TEA) using opioid and local anesthetic combination . The benefits of IOA versus TEA are unproven in adolescents . A retrospective chart review was performed to compare the pain outcome between these two pain management techniques.

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