giving kids room to breathe
Christopher Cardenas was supposed to live only 72 hours. But thanks to an invention by Health Science Center surgeon Robert M. Campbell, Jr., MD, Chris celebrated his 10th birthday in December.
Born with a rare birth defect, rib agenesis, seven of 12 ribs on his right side were missing and he had no chest muscles on that side. Since the rib cage acts as support and protection for the lungs and other organs, this lack of support meant that his organs would shift, his right lung would not grow normally, and he would develop curvature of the spine (scoliosis).
Chris was a fighter from the beginning. When he lived beyond that first 72 hours, his parents, Monica and Gus Cardenas, saw the milestone as a sign of hope and inspiration. For seven months he was respirator-dependent, and his parents continually sought help for him. To be nearer family members, the trio moved from Austin to San Antonio when Chris was 8 months old. Here they met Melvin D. Smith, MD, clinical professor of surgery, at the Health Science Center.
According to Dr. Smith, Chris’ heart was strong and his right lung was potentially good--it just needed a place to work. Dr. Smith then set about finding assistance "from someone who had wild ideas like I did." That other person was Dr. Campbell, an associate professor of orthopaedics at the Health Science Center with previous engineering experience. Dr. Campbell fashioned a prosthesis with pins used to set bone fractures, and Dr. Smith added a Dacron¨ Silastic Reinforced Sheet--it essentially acted as a chest wall for Chris. The surgeons' initial effort would work for the short term, but Chris was growing, and Dr. Campbell knew he must immediately begin designing a long-term prosthetic implant.
From this urgent situation, the titanium rib was born. The expandable prosthesis is implanted in a vertical position and attached to an upper and lower rib. The device helps maintain the chest space where there were missing ribs, thus allowing room for heart and lung development. As the patient grows, the prosthesis is simply expanded through an outpatient surgical procedure.
More than 45 children have received the titanium implant over the last decade--without the prosthesis and surgery they could have become dependent on respirators. This year Drs. Campbell and Smith began performing titanium rib implants under a multicenter study, including Boston Children's Hospital and Children's Hospital of Pittsburgh.
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