Physiological Assessments During Non Operative Treatment on the Chest Wall Deformities (PECTUS)

Physiological Assessments During Non Operative Treatment on the Chest Wall Deformities. Pectus Excavatum Pectus-Carinatum. Single-center Study

The physiological assessment in non-operative treatment on chest wall deformities, are still unclear today. These functional benefits outweigh the aesthetic benefits associated with anatomical improvement. The functional benefits, ventilation, hemodynamic and neurologic, have never been evaluated. Assessment of Effects on parasympathetic activity of the autonomic nervous system, global health criterion measured by noninvasive methods. Anatomic evaluation, between the initial and final assessment by objective measures 1) of the chest wall by MRI, and 2) of the heart by echocardiography. Noninvasive physiological assessment at rest and during exercise in respiratory function exploration flows and volumes, cardiac function by flow measurement, and overall metabolic function test effort (VO2max). Subjective assessment of functional gain between the initial and final balance sheet, based on EVA scales, valued by patients, parents and doctors.

Pectus Excavatum, Pectus Carinatum, Vacuum Bell, Dynamic compression system, Hearth variability, Autonomic Nervous System

Patients with pectus excavatum who do not require surgery, will be treated with the Vacuum bell device.

Patients with pectus carinatum who do not require surgery, will be treated with the Dynamic Compression System.

It is a reflect of the RR short term heart rate variability (HRV) in the frequency domain. It is measured with a ECG Holter monitor

It is expressed in litres per minute and is measured during a pulmonary function testing. The patient is seated and his/her nose is blocked with a clamp. He/She must blow as fast and as hard as possible.

It is measured by a thoracic MRI. It is the ratio between the thoracic width and the distance sternum/spine.

Inclusion Criteria: Patient with pectus excavatum or pectus carinatum who does not require surgery Patient with sufficient displacement of the chest wall during an initial test carried out during the first consultation :For pectus carinatum correction must be obtained with a pressure lower than 9 psi (pound per square inch). For pectus excavatum less than 250 mbar depression. Signed informed consent Subject (or parents) affiliated to the French National Health Insurance Exclusion Criteria: Skeletal disease, disturbing bone strength as osteogenesis imperfect and osteoporosis. Uncontrolled coagulopathies. Marfan syndrome, with mitral valve prolapse for pectus Excavatum. Atrial fibrillation Taking antiarrhythmic drug.