Pectus excavatum repair using autologous perichondrium for sternal support.

The support of the lower sternum following repair of pectus excavatum using autologous perichondrium from the lower costal cartilages to supplement the standard Ravitch's repair has been used effectively in 29 children during the past 14 years. This technique helps prevent recurrent sternal depression, particularly when the operation is performed in preadolescent children. Most adolescents and adults with pectus deformities as well as patients requiring reoperation will benefit from an internal prosthesis for the sternum that supplements the perichondrial support to reduce the frequency of subsequent sternal depression. Using the described operative technique, an excellent cosmetic and functional result was obtained in 27 children. Recurrent sternal depression of mild degree that occurred in two patients in the first four months postoperatively was related to trauma and possibly to decreased vascular supply to the lower sternum but neither required additional therapy. The internal mammary vessels should be preserved with the lower sternum whenever feasible.