Avances en evaluaciones anatómicas y fisiológicas en el tratamiento del Pectus Excavatum

Abstract

Pectus Excavatum (PE) is a congenital chest wall deformity characterized by an anterior depression of the chest wall and the sternum, which situates under the level of the anterior costal arch. It produces a decrease in the distance between the sternum and the vertebral body, displacing the intra-thoracic organs in a variable extend depending on the type and grade of the deformity. The anatomical evaluation of the deformity requires diagnostic methods, which carry radiations such as the computerized tomography, or are expensive as the magnetic resonance. Therefore very little tools exist to objectively assess the evolution of the thoracic deformities during growth or their response to different non-operative treatments. As radiating studies are reserved for severe cases in order to plan surgical correction, mild or medium grade deformities cannot be monitored or evaluated appropriately. On the other side, although these patients with PE may present different symptoms, this condition is still considered a mere aesthetic problem in some ambits. Several studies show that these patients have a decreased capacity for sportive efforts, and also this entity has been related to manifestations as syncope and arrhythmias. Nevertheless, up to date the physiological mechanism, which explains these results, has not been demonstrated. So, the debate about the physiologic implications in PE and the beneficial effects of the surgical correction on the cardio-pulmonary function persist, although the scientific evidence of the last years supporting its benefit. The aim of this Thesis (by article compendium) is to deepen in the diagnosis und management of PE from the physiological and anatomical point of view, in order to optimize the management and treatment of these patients; on the one side studying the applicability of a non radiant 3D external scanner system in the evaluation of the chest wall deformities, on the other side analysing cardiologic changes during PE correction.

Date of Award	4 Apr 2022
Original language	Spanish
Supervisor	Manuel Armengol Carrasco (Director) & Manuel López Paredes (Director)