Pectus Excavatum - Cincinnati Children's Hospital

How is Pectus Excavatum Treated?

Sometimes mild abnormalities can be corrected with a non surgical vacuum bell treatment while patients with moderate to severe abnormalities may require surgery, which is usually not done in children younger than age 8. Since children have softer cartilage and more flexible bones than adolescents, the operation is easier to perform on them and the cosmetic results are superior. However, good outcomes are now being obtained even in young adults.

Infants and very young children are usually not considered for surgery unless very severe abnormalities or other illnesses necessitate earlier surgery.

What Are The Surgical Procedures for Pectus Excavatum?

Both traditional open surgery (Ravitch repair) and minimally invasive techniques (Nuss repair) are used to correct pectus excavatum. Both techniques generally improve chest appearance. They also improve the structure of the ribs and sternum, as well as the function of the heart and lung. Both techniques result in a return to normal activity and improved exercise tolerance within the first few months following surgery.

Deciding which surgical approach to use is based on a number of factors. These factors include:

• The surgeon's level of expertise with each of these two techniques
• The severity of the defect and its symmetry (in the middle or more to one side)
• The child's age

Minimally invasive surgical techniques such as the Nuss Procedure have been used for more than three decades. With this approach, two small lateral incisions are made. A bar that has been shaped to the desired chest contour is inserted into and across the chest and positioned below the sternum. This is done using the guidance of an endoscope (instrument used to visualize the inside of the chest). The bar is held in place by sutures and by a small metal plate that prevents rotation of the bar as the chest is reshaped.