Pectus Excavatum Clinical Trial
Official title:
Phase II Magnetic Alteration of Pectus Excavatum
This is a medical research study.
The study investigators have developed a method to gradually repair pectus excavatum (sunken
chest) deformity by placing a magnet on the sternum (breastbone) and then applying an
external magnetic force that will pull the sternum outward gradually.
Potential candidates for this study are children and adolescents with a previously diagnosed
congenital pectus excavatum (sunken chest) deformity who are otherwise healthy and are
seeking corrective surgery for their condition. They will be residents of the U.S. and
between the ages of 8 and 14 years of age. Potential candidates and their families will have
already been counseled about this condition and about the standard way to repair this
deformity.
The purpose of this study is to test what effects, good and/or bad, placing an
external/internal magnetic device has on correcting pectus excavatum deformity in children,
and the safety of using such a device for treatment.
Pectus excavatum is the most common congenital chest wall abnormality in children. Surgical
correction requires a big operation under general anesthesia which forces the sternum
forward and holds it in place using a metal chest wall strut. Deformation of the chest wall
under great pressure may result in complications and potential relapses as well as
postoperative pain requiring hospitalization for regional and narcotic anesthesia for up to
a week. An alternative principle for correction of chest wall and other deformities is
gradual (bit-by-bit) correction using minimal force applied over many months (like moving
teeth with orthodontic braces).
The hypothesis of this study is that constant outward force on the deformed cartilage in
pectus excavatum will produce biologic reformation of cartilage and correction of the chest
wall deformity.
The study investigators have developed a novel method of achieving gradual
deformation/reformation of chest wall cartilage without the need for transdermal orthopedic
devices or repeated surgeries. A magnetic force field is used to apply controlled, sustained
force to promote biologic reformation of structural cartilage (the same principle as
distraction osteogenesis). A magnet is implanted on the sternum and secured using a novel
fixation strategy that can be accomplished through a 3-cm subxyphoid incision as a brief
outpatient procedure. The magnet (and sternum) is pulled outward by another magnet suspended
in a novel, low-profile, lightweight device previously molded to the patient's anterior
chest wall. The external magnet allows individual adjustment in small increments of the
distance (and, thus, force) and orientation of the force applied to the sternum. The
low-profile, non-obtrusive anterior chest wall prosthesis is held in place by the force
field between the two magnets.
The study objectives are to test the safety and probable benefit of this procedure in 10
otherwise healthy, young patients, between 8 years and 14 years of age, who have chosen to
have this deformity corrected using this novel technique rather than the standard Ravitch or
Nuss techniques. We will document the rate of correction by chest imaging and measurement of
the Pectus Severity Index. The study investigators will document safety and efficacy with an
EKG prior to implantation, one month post-implantation, and finally after the magnet is
removed, as well as patient and family satisfaction with a post-procedure Quality of
Life-type survey.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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