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Pectus excavatum originally was thought to be more of a cosmetic defect that people didn’t like the way their chest appeared. And we found through studies though, that patients with pectus excavatum do have lower measurable pulmonary function tests, their ability to gain the most oxygen when they exercise is lower. Oftentimes they’ll have mitral valve prolapse, and as they age, that’s when all of these problems are exacerbated. When you are a child and you have this, you have excellent cardiopulmonary reserve. You’re able to run faster and longer than ever in the rest of your life, practically. As we age, our cardiopulmonary reserve decreases and our chest walls become less pliable because our cartilages now have more calcium in them. And those are the patients that have more trouble in terms of doing regular things, walking up and down stairs, sometimes requiring oxygen to go through their everyday lifestyle. And certainly once they get to a certain age where they have heart disease, where now their arteries aren’t working so well in their heart, this exacerbates that problem. Ideally, this is something that should be addressed in childhood / adolescence, because that is when the cartilages are most flexible, most easily repaired. We can still operate on patients when they’re older, however, it becomes a slightly more difficult procedure. However, it is possible.
