Pectus excavatum care at Mayo Clinic

Pectus excavatum care at Mayo Clinic

I would describe pectus excavatum as a congenital chest wall anomaly that causes the sternum to be concave and it's an abnormality of the costal cartilages not necessarily the sternum, so you see a pectus excavatum get worse during a growth phase of a child.

Patients can breathe better after having this corrected it also improves their self-esteem.

The surgery is very routine here at mayo clinic we do 30 to 50 a year we've done over 500 since we started doing these procedures.

And because we've added cryotherapy to our pain management program, we've gone from a four to five day hospital stay now to an overnight procedure so people can come in have their surgery and go home the next day.

We use a minimally invasive cryoablation probe to freeze the intercostal nerves temporarily which results in patients having a very low or no opioid requirement after surgery. They're able to ambulate the same day and they're able to go home the next day often without any opioids at home either. It's really revolutionized pain management after this procedure.

The children's center at mayo clinic is a multi-disciplinary group of people it's not just pediatricians.

We have the expertise of multiple world experts that will work with us to provide the expert level of care that you deserve.

Ultimately our goal is to get them back home and getting them back to a happy healthy life.

Your Mayo Clinic care team

Specialists in cardiology, pulmonary medicine, thoracic surgery and rehabilitation medicine work together to develop the best solution to your problem.

Advanced diagnosis and treatment

Surgeons use the latest imaging technology and minimally invasive surgical techniques to treat people who have pectus excavatum. Surgeons may temporarily freeze certain nerves during the procedure to help provide pain relief during recovery.

Surgery restores active life

I was running five six miles a day and then all of a sudden, I couldn't run one mile and then I was texting my mom the next day I couldn't walk a mile. And then I couldn't even walk up my stairs to my apartment.

I've danced my entire life. I danced her studio growing up I danced in high school. I cheered in college and then I was even a professional NFL cheerleader and that's when I got admitted back to a hospital at St. Louis where I stayed there for about two weeks.

When they sent me home with an oxygen tank and said this is gonna be your life that wasn't an option for me. I knew that that the end of the road for that hospital but my mom and I we're not going to give up and we came across Dr. J on Google when we typed in number one surgeon for pectus in the world she popped up and we thought immediately we had to go to Dr. J.

Danielle describes very classic symptoms for pectus excavatum. The patient's feel like they can't get enough breath when they exert themselves, they become extremely short of breath they get lightheaded they feel dizzy.

Hi. I'm Dawn Jaroszewski. I'm a thoracic surgeon here at Mayo Clinic in Arizona and my specialty is pectus excavatum, It's something that I've done for years and the majority of my practice is focused on chest wall deformities.

Pectus is a very common chest wall deformity. It's actually the most common congenital one and it involves the front part the anterior chest wall caving in and it can be in a variety of locations sometimes it's low sometimes it's wide and flat. The problem with excavatum is that when the chest goes in it actually creates pressure or compression on the heart and lungs.

I think the mental game is sometimes harder than physically because that I think it was hard for doctors to separate my physical symptoms versus my anxiety and just thinking it was a mental game for me so being told I was crazy and just basically taking anxiety medicine you'll be fine versus you have an issue with your heart and your chest because at that time they did a standing echocardiogram and that was when we determined that my right ventricle was getting completely pinched off and I was losing 60% of blood flow when I would stand out which my next procedure that Dr. J did cured that for me.

It was amazing because her defect was very severe and her heart was nearly completely compressed, squished by the way her chest goes inward. And if you think about what the hearts function is it's basically just a pump so your body needs blood and the blood carries oxygen and when you exercise you need more oxygen and so the heart does at two ways; one it beats faster so more blood goes through more quickly and two it expands and increases the volume they call it stroke volume and so what happens with pectus patients is that the heart is compressed so the only way it has to give you more is to beat faster. Because it's restricted it can't increase that volume and so what you see is patients are fine when they sprint or they do really short things but anything with endurance anything when they're pushing out they just run out of steam because the heart just beats for as long as it can it can't keep up.

I have two stainless steel bars they've been in for about six months, and I get to keep them in for three years. Plus, I was up and walking the day after surgery. I was walking laps around Mayo Clinic again even before meeting her she was my superhero if you will. I just felt like I already knew her right when I met her for the first time she walked in the room I gave her a big hug I was like he's that awkward? I'm sorry I don't care if it is I just I knew she was gonna save my life if you will you know as she was the only person in my eyes who was gonna do that for me.

It was a long frustrating and frankly very scary road for Danielle trying to find out what was wrong with her and fortunately she made it here and we were able to diagnose her do the testing that we needed to to confirm that what was going on symptom wise for her was truly related to her pectus excavatum and do the surgery correctly to fix her.

My piece of advice for other patients who maybe feel alone or scared or like they have nowhere else to turn: Make a phone call to Dr. Jaroszewski fly out here in Phoenix and meet with her. She and her team of cardiologists will make you feel so confident comfortable and help you understand your body more it is scary. Meeting with Dr. Jaroszewski will just reassure you that you're gonna be okay and you know you're in the best hands possible.

Expertise and rankings

Pediatric and chest (thoracic) surgeons at Mayo Clinic are skilled at performing complex pectus excavatum repair surgeries in both children and adults. Mayo doctors typically see around 1,000 children or adults with pectus excavatum every year.

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March 31, 2022

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