Pectus excavatum is seen in what lesions?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on July 01, 2025
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Pectus excavatum can be divided into two categories: The first type is simple pectus excavatum, and the second type is pectus excavatum combined with other diseases. Simple pectus excavatum is a condition in itself and can exist independently, meaning that children with pectus excavatum may not have other pre-existing diseases. Of course, there is also pectus excavatum combined with other diseases, the most common of which are connective tissue disorders, where the incidence of pectus excavatum is significantly higher among patients. This suggests that pectus excavatum may be closely related to the genes that promote or inhibit cartilage development. Additionally, pectus excavatum may also be related to diseases in patients with congenital diaphragmatic hernia. Some cases of congenital Marfan syndrome may also be related, as well as some children who might have airway stenosis or congenital diseases of the lungs and bronchi. These types of congenital diseases may also be accompanied by pectus excavatum. In summary, whether it is simple pectus excavatum or that combined with other diseases, it can itself form a pathological condition and may also be accompanied by other congenital diseases, leading to secondary pathological changes.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Funnel chest surgery principle

The Wang procedure, named after Director Wang Wenlin from the Second People's Hospital of Guangdong Province, is a surgical method for correcting pectus excavatum. Traditional minimally invasive techniques for correcting pectus excavatum, such as the Nuss procedure or its modifications, involve placing a metal bar under or behind the sternum, forming an arch to lift the depressed area, similar to a traditional arch bridge. In contrast, the Wang procedure positions the metal bar on top and in front of the sunken sternum, and then uses stainless steel wires to suspend the deformed sternum forward and upward, transforming the traditional arch into a modern cable-stayed bridge, thus suspending the depressed chest area.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Can funnel chest be cured?

In fact, many diseases cannot be completely cured, including the common cold, for which there is currently no way to completely eradicate it, meaning there isn't a medicine that, once taken, prevents one from ever catching a cold again. Of course, this has a lot to do with the mutations of the cold virus. However, pectus excavatum can be cured, and there are generally two methods of treatment for it: surgical and non-surgical. The surgical method is suitable for older patients with harder bones. Conservative treatment is appropriate for younger patients with more elastic rib cages, who can cooperate well, or whose family can supervise and support them through this non-surgical approach. Regardless, it is completely possible to cure pectus excavatum, and there are methods to do so.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pectus excavatum heart hazards

Pectus excavatum can harm the patient's or child's heart, primarily manifesting in compression of the heart and affecting the function of the internal heart valves. Imagine a normal person's rib cage, which is oval in cross-section. There is a certain ratio between the lateral diameter and the anterior-posterior diameter, with normal individuals having a ratio of less than 2.5. However, in patients with pectus excavatum, this anterior-posterior diameter is significantly compressed, meaning the sternum moves closer to the spine, compressing inward and backward, squeezing the heart - this is the first step. The heart itself is a contractile muscular organ, its purpose being to eject blood and circulate it throughout the body. If the sternum and spine directly compress the heart, preventing it from fully expanding, then blood cannot fully flow back into the heart, and thus the ejection or pumping function of the heart will be impacted. Secondly, besides the heart being compressed, just like a house becoming deformed from being squeezed, the doors within the house cannot function properly; they cannot close or open well. Thus, pectus excavatum not only compresses the heart itself but also severely harms the function of the heart valves, even causing mitral valve prolapse in some patients.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Is pectus excavatum hereditary?

In current medical technology, although no genes exclusively associated with pectus excavatum have been identified, there is evidence suggesting genetic predisposition when pectus excavatum coincides with other conditions. For instance, the incidence of pectus excavatum is significantly higher in patients with congenital connective tissue disorders, such as Marfan Syndrome, and is linked to certain genes within this syndrome. Additionally, patients with congenital diaphragmatic hernia also show an increased incidence of pectus excavatum. Moreover, the condition is more prevalent in patients, or children, who have subglottic airway stenosis or congenital bronchopulmonary dysplasia. Thus, these evidences confirm that pectus excavatum, as a disease in itself, is directly or indirectly related to congenital genetic factors, indicating a certain hereditary nature.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pectus excavatum causes

The etiology of pectus excavatum is not fully clear yet, but it has been found that the incidence of pectus excavatum greatly increases among patients with connective tissue diseases, possibly related to the disruption of the balance between growth genes and inhibitory genes affecting the cartilage on both sides of pectus excavatum. Moreover, it is also found that the complication of pectus excavatum significantly increases among patients with Marfan syndrome (also a type of connective tissue disease) and Noonan syndrome. In children with congenital airway stenosis and bronchopulmonary dysplasia, the incidence of pectus excavatum also significantly increases. This suggests that the causes of pectus excavatum are directly or indirectly related to genetics and heredity, and regardless, the causes of pectus excavatum, both acquired and congenital, are directly related to genes and heredity.