PectusCheck offers the latest diagnostic and minimally invasive treatment options including non-surgical approaches such as bracing.
Specialist diagnostic tests can rule out clinical concerns of heart or lung disorders.
PectusCheck offers onward referral to Specialists if indicated, for example when assessing for Marfan Syndrome or if in need of further psychological supports.
PectusCheck has been set up by Specialist Screening Healthcare Ireland to offer:
- Specialist advice with investigations for your pectus or chest wall deformity.
- Raise awareness on the latest minimally invasive techniques available for pectus and chest wall conditions.
- Opportunity to liaise with patients who have undergone pectus and chest wall surgery.
Specialist Screening Healthcare Ireland’s PectusCheck service is a unique programme in Ireland offering specialist diagnostic tests combined with a consultant thoracic specialist opinion to individuals from 12 years of age through to late adulthood that have a range of the following symmetric or asymmetric pectus and chest wall conditions.
PECTUS EXCAVATUM
PECTUS CARINATUM
POLAND SYNDROME
RIB FLARE
Physical Examination/Inspection & Consultation with Consultant Thoracic Specialist Surgeon
Our PectusCheck service includes quality time (either face to face or video conferencing) with our thoracic specialist to evaluate and advise treatment options of your pectus and / or chest wall condition.
Professor Karen Redmond has expanded a range of minimally invasive surgical approaches to treat patients in Ireland with pectus and chest wall deformities. Professor Karen Redmond is the only consultant thoracic pectus specialist in Ireland that offers new minimally invasive innovative techniques including 3D custom made reconstruction implants and pectus-up surgery. Until very recently, patients with pectus excavatum or poland syndrome had to travel to the UK to seek their preferred treatment choice. Professor Karen Redmond has expanded her surgical repertoire to avoid patients having to go through higher risk operations including open repairs such as Ravitch.
Education & Access to Pectus & Chest Wall Treatment Options
Depending on the type of chest wall deformity and problem the best option for a successful outcome will be discussed. Professor Karen Redmond is trained in open technique surgery (Ravitch) but is also trained in newer innovative minimally invasive technologies that significantly reduces post-operative morbidity to include the following:
- Custom-Made Reconstruction Implant Surgery
- Nuss Bar Surgery
- Pectus-Up Surgery
- Pectus Bracing
Specialist Diagnostic Investigative Tests
(rule out concerns of clinical complications)
Specialist Diagnostic Investigative Tests
Echocardiogram Ultrasound (rule out causes for shortness of breath or valvular abnormalities linked to Marfan’s Syndrome)
An echocardiogram is an ultrasound of the heart. It can show real-time images of how well the heart and its valves are working. It is important to rule out aortic pathology linked to Marfan Syndrome.
Pulmonary Function Tests (PFTs) with Bronchodilator Response
Pulmonary function tests (PFTs) also known as lung function tests are a group of non-invasive tests that measure how well the lungs are working. This includes how well the lungs can breathe and how effective the lungs are with gas exchange. Pectus and chest wall deformities depending on their severity can restrict movement of the chest wall impairing lung function. The tests measure lung volume, capacity, rates of flow, and gas exchange. Bronchodilators open or dilate the airways in the lungs. The test aims to measure if the abnormalities found on the baseline breathing test are reversed with administration of a bronchodilator, suggestive of asthma.
3D Scanning Software Using an Attached Structure Sensor & iPad for Pectus Carinatum
Specialist Screening Healthcare Ireland’s PectusCheck services takes a 3D Scan of your pectus carinatum or chest deformity along with photos using a Structure Sensor connected iPad. T-Scan software precisely measures and analyses the chest deformity to aid in the fabrication of a fully customized T-Joe Pectus Brace. 3D Scanning is safe with no harmful radiation. Additional scans are taken during treatment to monitor progress and improvement during treatment.
3D Computed Tomography (CT) Chest Reconstruction Scan for Pectus Excavatum & Poland Syndrome
A CT chest non-contrast scan is often used to help determine the severity of a pectus excavatum and whether the heart or lungs are being compressed. In a CT scan, an X-ray beam moves in a circle around your body. It takes many images, called slices, of the lungs and inside the chest. These images are more detailed than regular X-rays. A CT scan is one of the best ways of looking at soft tissues such as the heart and lungs.
Importance of the Haller Index (HI) or Pectus Index (Calculating the Severity of a Pectus Excavatum)
The Haller Index (HI) also known as the pectus index is an accepted Computed Tomography (CT) method for evaluating thoracic or chest dimensions in patients with pectus excavatum. It measures how wide the chest is as compared to its depth. The higher the HI, the deeper the Pectus Excavatum. The HI has emerged as the predominant way to identify pectus excavatum patients for which surgical treatment is most appropriate. Generally, a HI greater than 3.2 warrants repair if the patient is symptomatic either physically or psychologically.
Comprehensive Pectus/Chest Wall Analysis Report
On completion of every PectusCheck screening, Specialist Screening Healthcare Ireland provides a comprehensive medical summary including a detailed analysis of all test results from our consultant specialists directly to you and your General Practitioner with a copy of all test reports completed. CT images will be provided on disc to each patient.
Supplementary Tests & Referrals
(Included in PectusCheck Screening if Clinically Indicated)
Referral to a Marfan Syndrome Specialist
Pending the result of your echocardiogram (ultrasound of the heart) Specialist Screening Healthcare Ireland will refer your clinical pathway directly to a Marfan syndrome consultant specialist.
Marfan syndrome is a genetic disorder that causes abnormal development of fibrillin, which is a component of the connective tissue. People with Marfan syndrome are usually tall and thin with disproportionately long arms, legs, fingers and toes. The most serious risks associated with the disease occur in the heart and aorta: weakness of the connective tissues puts patients with Marfan syndrome at risk for aortic aneurysm, heart valve disease, and aortic dissection.
Evaluation of the aorta and aortic root should be performed in individuals with suspected or confirmed Marfan syndrome. 90% of people with Marfan syndrome have heart involvement.
Referral to Clinical Phycologist if Clinically Indicated
It is well documented that individuals with Pectus and chest wall deformities are affected by their body image, and can often experience embarrassment, have low self-esteem and feelings of shame over the perceived differences in their physical appearance and that this can lead to depression, shyness and social anxiety.
Generally, this can be addressed and resolved by talking with friends or family however, there may be occasions when this does not seem possible and when support from an independent or more specialist source feels appropriate. This is when clinical psychologists are ideally placed to help. Specialist Screening Healthcare Ireland will refer your clinical pathway directly to a clinical psychologist if clinically indicated.
PectusCheck Fees
PectusCheck, Ireland’s newest thoracic chest wall screening service offered by Specialist Screening Healthcare Ireland charges a self-pay fee totaling €1,495.00, qualifying for tax relief on payments made. Tax relief is available at the standard rate of tax at 20% via the Department of Revenue. You will be issued a receipt which you can submit to revenue as they may require a copy of proof of payment.
If you have private health insurance, some insurance providers reimburse their members for health screening. Please check with your insurance provider if your membership plan will reimburse any, all or part of the cost. You may receive a percentage reimbursement on the fee paid but this is dependent on your specific insurer and insurance policy.
If you have any queries regarding reimbursement please contact your health insurer to discuss the outpatient portion of your specific policy plan. You can claim tax relief on the portion not covered by your health insurer.
Cardio Pulmonary Exercise Testing (CPET or CPEX)
This is a specialised type of stress test or exercise test that measures your exercise ability to see how your lungs, heart and muscles react together when you exercise. During the test, you walk on a treadmill. How much air you breathe, how much oxygen you need and how fast your heart is beating when you exercise is measured.
This test helps determine if the decreased tolerance to exercise or shortness of breath with activity the patient is experiencing is caused by their pectus or chest wall condition. CPET is usually used when the shortness of breath (dyspnea) is not easily explained. Cardiopulmonary exercise testing aims to measure the rate that a patient’s body takes in oxygen and produces carbon dioxide while monitoring ventilatory parameters, heart rhythm, blood pressure, oxygen saturation during maximal exercise.