Pediatric Chest Wall Clinic

The defect can apply pressure and displace the heart and lungs. Pectus excavatum correction surgery can be performed by pediatric thoracic surgeons, cardiothoracic surgeons and orthopedic surgeons. Treatment options include the suction bell (vacuum bell), the Ravitch procedure (an open surgical repair) and the Nuss procedure (a minimally invasive operation). The defect typically worsens during adolescent growth spurts and can be corrected surgically starting at 12 years old.

The defect typically doesn't apply pressure to the heart or lungs, but can cause atypical chest pain and breathlessness on exertion. Carinatum defects can be treated noninvasively with bracing at almost any age, or surgically during adolescent years.

We also offer intraoperative cryoablation therapy (temporary freezing of nerves) and intercostal nerve block (local anesthetic injection, like at the dentist) for postoperative pain management, allowing most patients to be discharged the day after surgery or even the same day.

Postoperative activity will be tailored for each patient based on the surgical approach and condition. Children undergoing the Nuss repair can return to normal activity, including contact sports, six weeks after surgery.

• An incision is made across the child’s mid-chest area.
• The rib cartilage is surgically removed, and the sternum (breastbone) may need to be cut. A small bar may be placed behind the sternum and left in place for six months. This bar must be removed as an outpatient procedure no earlier than six months after insertion.
• One or more drains are placed under the skin to drain fluid from the surgery site. These drains are removed one to two days after surgery, typically before going home.

In the months after surgery, the cartilage regrows and keeps the breastbone in the new position.