What is pectus excavatum?
Pectus excavatum occurs when the cartilage, sternum (breastbone), and ribs do not form and grow properly, leaving an indentation in the chest wall. Also called “funnel chest” or “sunken chest,” pectus excavatum is usually detected at birth and can worsen as the body develops during adolescence. Our team of experts specializes in the treatment and management of pectus excavatum in children, teenagers and adults.
Symptoms
In most cases, symptoms are subtle. Some individuals experience no symptoms at all. However, if symptoms develop or worsen, surgical correction may be advised.
Impact on Heart & Lungs
At UChicago Medicine, our specialists work hand-in-hand with cardiac imaging experts, using chest CT scans and echocardiograms to understand how pectus excavatum affects heart and lung function.
In moderate and severe cases, the sunken breastbone can press on the heart or lungs, causing:
- Shortness of breath during exercise
- Rapid heartbeat or palpitations
- Wheezing or coughing
- Chest and back pain
- Heart murmur
- Decreased stamina/increased fatigue
Psychological & Social Effects
Although pectus excavatum is a physical deformity, it’s important to understand the significance of its potential impact on self-consciousness and quality of life. This is one of many important considerations as our specialists develop customized care plans.
Surgery
When surgery is recommended, our team of experts determines the most appropriate approach based on each individual’s unique needs. Our UChicago Medicine surgeons perform innovative techniques with exceptional skill and excellent outcomes.
A minimally invasive approach to pectus excavatum repairs, the Nuss procedure offers faster recovery time and less scaring than traditional, open surgeries. During the procedure, a surgeon makes a small incision on either side of the chest and then custom fits a curved steel or titanium bar for the patient’s chest wall. The bar is introduced through the incisions and is tunneled under the sternum. The bar is rotated into place and elevates the sternum, which corrects the defect. On occasion, two bars are required to fully correct the pectus deformity. During the procedure, a small camera (thoracoscope) monitors bar placement to decrease the risk of injury to surrounding structures. The bar usually stays in place for two years or more. The operation to remove the bar is performed on an outpatient basis.
During the Ravitch procedure, an incision is made along the chest wall over the sternum. Our surgeons use a modified Ravitch approach, which involves making incisions as small as possible. A surgeon will remove cartilage around the area of deformity, detach the sternum and then reposition it. Sometimes, a small metal bar is also placed under the sternum to support it in the desired position. The bar is usually left in place for about two years until the cartilage can solidify in the new corrected position. The operation to remove the bar is performed on an outpatient basis.
