Pectus excavatum repair




Definition

Pectus excavatum repair, also called "funnel chest repair" or "chest deformity repair," is a type of surgery performed to correct pectus excavatum, a deformity of the front of the chest wall with depression of the breast-bone

In a minimally invasive pectus excavatum repair, two incisions are made on opposite sides of the chest. A clamp is guided beneath the sternum to create a tunnel for the bar (A), which is then fed through (B). The bar is turned over to push the sternum out (C and D) and attached to the ribcage. (Illustration by Argosy.)
In a minimally invasive pectus excavatum repair, two incisions are made on opposite sides of the chest. A clamp is guided beneath the sternum to create a tunnel for the bar (A), which is then fed through (B). The bar is turned over to push the sternum out (C and D) and attached to the ribcage. (
Illustration by Argosy.
)


(sternum) and rib (costal) cartilages. It is sometimes associaated with Marfan or Poland syndromes.


Purpose

The chest consists of the rib cage and sternum, which protect the upper-abdominal cavity and its contents. Pectus excavatum, also called "funnel chest" or "depressed sternum" is a deformity that is usually diagnosed shortly after birth. In some people, it is not visible until they are older. The exact cause is not known, but it is believed to be due to overgrowth of the rib cartilage connected to the sternum, which results in the sternum being pushed backward toward the spine. Most people have no symptoms, but if the breastbone is pushed back far enough, heart and lung function may be affected. The purpose of pectus excavatum repair surgery is to correct the deformity to improve physical appearance, posture, and breathing.

Demographics

In the United States, pectus excavatum is the most common chest wall deformity observed in children, occurring more commonly in boys than in girls. Pectus excavatum tends to run in families. The funnel chest usually progresses as the child grows, often showing a dramatic deterioration during the puberty growth spurt.

Pectus excavatum repair is technically easiest to perform in preadolescent children, and the recovery is faster. However, almost half of the patients undergoing the operation are teenagers. Repair is rarely performed on children under eight years of age. In recent years, a large number of adults over the age of 21 years have undergone repair with equally good results as those observed with children.


Description

Pectus excavatum repair is always performed with the patient under general anesthesia. An epidural catheter is inserted for the management of pain after the operation. The surgeon makes two incisions over the sternum, on either side of the chest, for insertion of a curved steel bar or strut under the sternum. He or she proceeds to remove the deformed cartilages. The rib lining is left in place to allow renewed cartilage growth. The sternum is then repositioned, and the metal strut is placed behind it and brought out through the muscles and skin for future attachment to a brace, which will stay in place six to 12 weeks. The metal strut is fixed to the ribs on either side, and the incisions are closed and dressed. A small steel grooved plate may be used at the end of the bar to help stabilize and fix the bar to the rib. A blood transfusion is not required during surgery. The surgeon may insert a temporary chest tube to re-expand the lung if the lining of the lung is entered.

A variety of surgical procedures are available to repair pectus excavatum.


Nuss procedure

A common technique is the Nuss procedure, developed in 1987 by Dr. Donald Nuss, a pediatric surgeon at Children's Hospital of the The King's Daughters and Eastern Virginia Medical School in Norfolk, Virginia. The procedure is minimally invasive, and results in very little blood loss and short recovery times.


Leonard procedure

Another surgical approach that drastically reduces the time required for surgery is the Leonard procedure, developed by Dr. Alfred Leonard, a Minneapolis thoracic and pediatric surgeon. This operation does not violate the chest, and is combined with a bracing technique.

Diagnosis/Preparation

A pediatrician diagnoses pectus excavatum after observing a child when he or she inhales, exhales, and rests. The pediatrician also calculates the depth of the chest from front to back using x rays of the chest to determine whether the diameter is shorter than average, as is the case with funnel chest. The heart is usually larger and displaced to the left. The pediatrician also evaluates lung capacity using exercise tests and lung scans that can reveal mismatched lungs.

Other diagnostic tests may include:

  • Electrocardiogram (ECG or EKG). This test records the electrical activity of the heart, and shows abnormal rhythms (arrhythmias or dysrhythmias).
  • Echocardiogram (echo). This test evaluates the structure and function of the heart by using sound waves recorded on an electronic sensor that yields a moving picture of the heart and its valves.

Before surgery, a bone density test is performed to ensure that the patient does not have soft bones that would deform again right after the surgery. After a complete health history is taken, a patient whose condition is considered severe enough to warrant surgery is sent for a CT scan and further evaluation of his or her pulmonary function.

Because of the great variablity of pectus excavatum among those who have it, custom-made bars (or braces) must be used. The brace is a light vest to which the deformity-correcting wire will be attached at surgery. Patients are fitted with the brace prior to surgery.


Aftercare

Usual recovery time in the hospital is four to five days. Attention is paid to post-operative pain management . The patient is encouraged to breathe deeply, and receives assistance with movement (to avoid dislodging the bar). After discharge, the patient slowly resumes a normal, but restricted, activity level. Most children are able to return to school in two to three weeks, with exercise restrictions for six weeks (no physical education classes, heavy lifting, or athletics).

The pectus excavatum support bar is removed under general anesthesia two to four years after insertion, usually on an outpatient basis. In most cases, patients are able to leave the hospital within one to two hours after bar removal.


Risks

Risks associated with pectus excavatum repair include those normally associated with the administration of anesthesia (such as adverse reactions to medications and breathing problems), and risks associated with any surgery (such as bleeding and infection). Specific pectus excavatum surgery risks may include lung collapse (pneumothorax) and the recurrence of the funnel chest. Bar displacement may occasionally require repositioning.


Normal results

Pectus excavatum repair, in almost all instances, restores the ability of patients to participate in full activities, even strenuous activities and athletics. Also, there is a marked improvement in the patient's self image.


Morbidity and mortality rates

According to the National Institutes of Health (NIH), excellent results (95–98%) are reported over a lengthy follow-up time of 25 years. Long-term follow-up (over 15 years) shows that the Nuss procedure provides excellent results with less than 5% recurrence of the deformity after the bar is removed.

Alternatives

Mild cases of pectus excavatum may respond to an exercise and posture physiotherapy program. Many patients with rounded shoulders and a slouching posture have benefited from these techniques, with or without additional surgical correction. However, body-building exercises usually result in worsening of cosmetic appearance due to the enhancement of the pectoral muscles.


Resources

BOOKS

Pearson, F. G. Thoracic Surgery. Philadelphia: W. B. Saunders Co., 2002.

Ravitch, M. M. Congenital Deformities of the Chest Wall and Their Operative Correction. Philadelphia: W. B. Saunders Co., 1977.

PERIODICALS

Engum, S., F. Rescorla, K. West, T. Rouse, L.R. Scherer, and J. Grosfeld. "Is the Grass Greener? Early Results of the Nuss Procedure." Journal of Pediatric Surgery 35 (2000): 246-51.

Genc, A., and O. Mutaf. "Polytetrafluoroethylene Bars in Stabilizing the Reconstructed Sternum for Pectus Excavatum Operations in Children." Chest 110 (July 2002): 54-7.

Hebra, A., B. Swoveland, M. Egbert, E.P. Tagge, K. Georgeson, H.B. Othersen, and D. Nuss. "Outcome Analysis of Minimally Invasive Repair of Pectus Excavatum: Review of 251 Cases." Journal of Pediatric Surgery 35 (2000): 252-7.

Jacobs, J. P., J.A. Quintessenza, V.O. Morell, L.M. Botero, H.M. van Gelder, and C. I. Tchervenkov. "Minimally Invasive Endoscopic Repair of Pectus Excavatum." European Journal of Cardiothoracic Surgery 21 (2002): 869-83.

ORGANIZATIONS

American Pediatric Surgical Association (APSA). 60 Revere Drive, Suite 500, Northbrook, IL 60062. (847) 480-9576. http://www.eapsa.org .

Southern Thoracic Surgical Association. 633 N. Saint Clair St., Suite 2320, Chicago, IL, 60611-3658. (800) 685-7872. http://www.stsa.org/ .


OTHER

"Pectus Excavatum Repair." BestHealth. <www.besthealth.com/surgery/PectusExcavatumRepair_1.html> .


Monique Laberge, Ph.D.

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?



Pectus excavatum repair is performed in a hospital by experienced thoracic surgeons who specialize in pectus excavatum repair.

QUESTIONS TO ASK THE DOCTOR



  • Can exercises correct pectus excavatum?
  • How is pectus excavatum surgery performed?
  • Should everyone with pectus excavatum have surgery?
  • What surgical procedures does the doctor use?
  • How many pectus excavatum surgeries does the physician perform each year?

User Contributions:

Thomas
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Mar 4, 2006 @ 11:23 pm
I have this condition of Pectus excavatum also. But reading the said articles.. it methion of a "cave-in" chest bone.. but my is as "cave-out". Does it have the same effects with those whose are cave-in?
M
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Apr 26, 2006 @ 2:14 pm
Leonard or Nuss....

what would determine which prodecure a patient should undergo?
julian
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May 5, 2006 @ 6:06 am
Hi i have a sternum that is slightly pushed in. Im 16 and i have recently started bdybuilding. Is their any way, via doing exercises that i can make pushe out over time.

Thanks
Carla
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May 8, 2006 @ 6:18 pm
hello
i have a sternum that is also pushed in about 3/4 inch down. What could I do to make it go away...exercises? surgery? I am 14 years old and I noticed it only about a year ago. Thank you, and please contact me.
Tyler
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Apr 4, 2007 @ 3:15 pm
hey i was wondering my chest "caves in about half an inch is there a need for surgery or what exercises?
Humberto
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Aug 7, 2007 @ 7:19 pm
I Have this condition...pectus excavatum, Can i play soccer after the operation?? Please answer me...beto007799@hotmail.com
lew
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Aug 19, 2007 @ 1:13 pm
I'm 19 and I also have pectus excavatum, my chect curves in about 2 or 2 and a half inches. I was wondering how severe does this condition have to be to cause potential heart or lung problems?
furrakh
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Aug 20, 2007 @ 5:05 am
im looking for repair of my PE. please guide me. where are the best opportunities. i am so eager to do so.
furrakh
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Aug 20, 2007 @ 5:05 am
i am so much interested in nuss procedure. so i like nuss procedure to correct me PE.
Tommy
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Sep 28, 2007 @ 3:03 am
hi im 18 and having something like a pectus excavatum and was wondering if there was any form of exercise or any other way of curing this other than surgery
carlson
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Oct 22, 2007 @ 7:07 am
hi im 16 and i noticed my chest is pushed about 1 inch or a lil bitt more and im into body building. what can i do to let this go away and is body building bad or good for this?
Mark
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Oct 30, 2007 @ 6:18 pm
Hi Guys,

I have pectus excavatum as well..I first noticed it in puberty and I am 22 right now. I never worried about it because I always thought I would be able to 'fix' through exercise, since I am in to weightlifting and combat sports. But the truth of the matter is that the disorder only got worse.. I'm now thinking of getting surgery, but I am not sure because there is no physical need for it..it would be just for me to feel better in my own skin..Cheers
Jurgen
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Nov 7, 2007 @ 10:22 pm
Hi - I'm 27 years old. I've got Pectus Excavatum. I've lived with it and never had any problems. I'm a very active individual and after a Chest session (Bench press) in the gym I felt bone moving. Since then my condition has worsend and I feel like I've to gasp for breath, but when I do my morning 5k run - I feel fine. But then it worsens again during the day...Confused...should I get this Surgery done. Who does this in South Africa?
Hazel
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Nov 14, 2007 @ 8:08 am
i am 17 and have the dipression in my chest but as im female it is not that noticable because of my breasts. but my lower ribs stick out alot and as i am quite slim it is very noticable and makes me feel uncomfortable. the condition does not cause me much trouble but when i am in certain positions and especially when i am walking or carrying something i get very breathless and dizzy and can not fully breath in. i had breathing tests done at birmingham childrens hospital which said it was causing me no lung trouble but these tests were done sitting down only. i also have scoliosis and a rib that is out of place and too close to my heart for doctors to mess with and this is why i have been refused surgery. my doctors have discharged me but i am still not happy. because the condition does not cause any physical problems noticable to them i have been refused of any treatment. major surgery is not an option for me but i have recently found out about other methods of treatment that i was not informed about by my doctors such as the magnetic mini-mover. i would like to know more about these less major treatments and how i would go about getting them. my doctors have not pleased me and i would be very greatful for the help. x
Debbie
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Nov 25, 2007 @ 3:03 am
Hi, my 17 year old son has severe pectus excavatum and needs surgery. Does anyone know of any doctors in South Africa experienced in the Nuss procedure? I know Dr Nuss is FROM Cape Town but now works in the US. I would appreciate any comments.
Dora
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Nov 27, 2007 @ 9:09 am
Hi, My son is 17 years old and has severe pectus excavatum and has been denied surgery due to not having lung or heart problems according to all his tests that he had to perform. What has to take place in order to have this procedure done to correct this matter before it worsens? I just read that a young lady has it but Drs can't perform surgery due to a rib being to close to the heart.
Doug
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Dec 16, 2007 @ 10:22 pm
Hi my name is doug and i have pectas excavatum that goes 2 or 3 in. deep i was just wondering if i could play sports after the operation to fix it.
Joey
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Jan 3, 2008 @ 1:13 pm
Hello im 22 years old and my chest caves in. I was wondering what kind of exercises do i have to do to make it not show alot. if you have any ideas please send me an email.
John
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Jan 30, 2008 @ 1:01 am
I'm now 47 and have suffered this since about the age of 14. I lifted weights and did pushups and everything possible to fix it when I was a teenager. Nothing worked and now I just have big, ugly man tits. Just some advice for you young people, nothing I did made it become normal (and I did alot)...and... it is actually only a slight case of PE, about 1/2 to 3/4 inch. But I will say this. It made me who I am today, I wouldn't be the same person if it were normal growing up. While it kept me from doing many things like going to the beach etc. it also gave me alot of inner strength and charachter. That said...if I could have done the surgery that is possible today, I would have done it in a heartbeat!! I'm still considering doing something about it but I'm getting a bit old and not sure if it would be worth it. Good luck to all and don't let it get you down.
Mike
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Apr 6, 2008 @ 11:23 pm
Hi, I am 19 and I have a pretty deep funnel. I was wondering if I could do anything?? Is it too late for surgery?? How long am I good for?? If you could just shed some light on this...i would really appericate this! Never been to a doctor and my folks never bothered. Please if u can send me an e-mail.
22Mark
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Apr 8, 2008 @ 3:03 am
I am 22 and I have done the pectus excavatum surgery by NUSS procedure. I can say that now I am pride of my chest, but only I know how I keep up with the pains in my chest due to the bar on cold or rainy day. Is 1 year since I done the surgery and if u want me to give u an advice: "Forget about your look, accept it, if not u have to know that the post surgery pains are huge!"
Victoria Rivera
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Jun 10, 2008 @ 1:13 pm
My son had surgery in November 2005 for PE correction with the Nuss procedure. His surgery was performed in Guatemala, but now we live in NY, and I am trying to find a doctor who does type of surgery. He is supposed to have the steel bar removed after three years (November 2008). I will appreciate any help on this.
Thank you,
rob
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Sep 18, 2008 @ 1:13 pm
Anyone who is diagnosed with pectus excavatum, should have something done at a younger age if possible. Now, that is of course, my opinion. I'm no doctor, but I'm 30 years old with a wife and daughter. Trust me; you don,t want to have to wait this long. I'm only waiting on the dr. now, pre-ops are done! Hopefully surgery will follow soon. Then I can get some mental clarity.
Dylan
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Oct 25, 2008 @ 1:01 am
hey, im 14 years old i have pectus excavatum and i noticed the problem when i was about 9 or 10 does anybody have any advice on excercises or surgery for me? -yeayeababyz@yahoo.com
george
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Nov 2, 2008 @ 5:17 pm
HI!! im a little bit impatient bcause i dont like to take my shirt off bcause i have spectus excavatum. If i do exercise this hole goona desapear or make it worse?? plz i need this, i want to be a wrestler!
James
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Nov 5, 2008 @ 12:00 am
hey, I am 18 years old and I have just discovered this site. I am not shure if I have a form of Pectus Excavatum, I have about a 1/2 inch depression in my chest, but I also have one side of my rib cage that that sticks out about 3/4's of an inch more than the other side. This basicaly means that my sternom is pushed in, but the one side of my chest sticks out. It is mostly cosmetic, but when i bend over forward I have very restricted breathing and chest pains on my one side that is pushed in, my right side to be exact. I didnt read any of your comments that talk about problems with particular sides of your chest but if there is someone dealing with a similar problem i would be so grateful to here how you are dealing with it or if there are even more people out there with my particulare issue. please talk to me I would realy appriciate a second oppinion.
James
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Nov 23, 2008 @ 3:03 am
Hi‚ I was wondering how long I should wait after this procedure to start weight lifting?

Many Thanks

James
Ray Flores
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Dec 30, 2008 @ 7:07 am
I have a 48 year old sister who underwent the Nuss procedure 7 months ago and is still in considerable pain associated with the bar. She is taking strong pain medication every 4 hours. She has consulted with the doctor who performed the procedure and he has said that "all the 40 + year old patients are OK". She has been to the ER several times and has had X-Rays with no obvious problems. Can anyone tell me if this is a normal condition and when the pain should have stopped or at least reduced to a tolerable level? If you have any comments, please send me an email to: rayflores@aol.com
Regards
Ray Flores
terri
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Jan 14, 2009 @ 8:08 am
My daughter has been diagnosed with Pectus excavatum after birth, she also has pulmonary stenosis, and vsd. She has been complaining of pain in center of her chest and ped. doc. reccomends surgery. Will her cariologist reccomend this to. She is 11 yrs. old.
thanks for any resources or info u can supply me!!!
hannah
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Jan 20, 2009 @ 6:06 am
hi im female, 15 years old and am not sure how bad my sunken chest may be, I have only recently heard of PE and thought that this could be what I have. the bottom of my sternum sinks in and the bottom of my ribs stick out allot. I'm going to go to a doctor soon but would be really grateful to see pictures of other cases, even mild ones so I can compare my condition. Please if anyone could send me some pictures that would be wonderful also label them with details (like how severe the condition, if there has been any treatment or if the doctor has said that it's fine.) THANX a heap.
hanxx
hannah
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Jan 20, 2009 @ 6:06 am
sorry for above wrong email address adress is hannahproudman@gmail.com
alexy
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Jan 30, 2009 @ 2:14 pm
hey i would like to know if my PE is bad i have a depresesion of 2.5 cm thanks
Heather
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Feb 6, 2009 @ 1:13 pm
I knew my PE was bad when I had shortness of breath, when I had a hard time doing mild exercise because of lack of energy and the inability to catch my breath, and had frequent pain in my chest area. I had surgery (Leonard Procedure) on my PE which ended up being a severe case when I was 17 and I have felt great ever since. I would reccomend sending recent chest x-rays to your PE surgeon of choice to gage the severity, that I what I did.
David Michel
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Feb 23, 2009 @ 2:14 pm
I am an exception to this procedure. I fall into the 5% or less category of having a reoccurence of my sunken chest with it worse than it was to start of with. I had my surgery when i was 15 years of age. My surgeon decided that the best approach for me was the Ravtich approach using the adkin's strut. Basically they made an incision on the side of chest and placed a 5 inch long titanium bar horizontally behind my sternum. i was scheduled to return back to have it removed 6 months later. however just 2.5 months later i was back in surgery because the strut bar had moved to an angle of 45 degrees upward on my left chest. so i was immediately rushed into surgery and had the bar taken out along with half my sternum and a good bit of my 4 lower ribs on my left side. I was told everything was going to be ok. i believed them cuz im not going to lie behind all the scars my chest was pulled out and i was just happy to look normal. well that didnt last too long. i kept growing and growing and my chest started to sink back in and i loss all feeling in that area in my direct center of my chest. not only was the scars horrific but my heart is completely visible. you can see the double beat to my heart perfectly granted it is still covered by a small layer of skin. its dangerous is how i look at it. if someone accidently hot me there i would be totally knocked out. well i am 20 now and i have finally gone back to the same doctors to see what we can to do to fix this new problem. they have me going through a bunch of tests and slightly told me of a different procedure. they want to take whats left of my sternum and rotate it so the front will be in and the back side will be out and then take bone from my knee and fill in the area that is lacking bone. i dont know much more than this considering i just saw them 2 weeks ago but they have a ton of surgeons involved now and honestly i just want all this to be over with. If ANYONE knows any details to this new procedure please email me at SupraCelica27540@yahoo.com please give me any information.
marisue
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Feb 23, 2009 @ 11:23 pm
My son is almost 28 and no Doctor ever told us he had pectus excavatum. I was shocked to hear he had it when he was about 20 years old. Later he went into the Army and just came back from Iraq. He wants to have surgery and it is very scary for me. He is beginning to have trouble breathing especially being in the Army.
He needs to find a surgeon that is experienced and preferably in Colorado but willing to go elsewhere for a more experience Doctor in repairing pectus excavatum. Please help us find the right procedure and the best Doctor for this procedure. Thanks so much for your advice. If anyone has any ideas or advice, I would love to hear from you. My email is: koalamsa@yahoo.com Thanks again.
Omar
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Mar 4, 2009 @ 4:16 pm
i am 15 years old and i have a funnel chest.. i am worried that as i grow older it will go deeper. is there any excersise i can do such as swimming or is surgery the only way.i have a depresesion of 2cm ..Should everyone with pectus excavatum have surgery?
Ashlie
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Mar 19, 2009 @ 7:07 am
I was diagnosed with PE from the time I was born (1984). At the time my parents were told this is completly cosmetic and everything would be fine. Once I started high school that's when we noticed I wasn't.

Growing up I was always getting respitory infections, I would have broncittis atleast twice a year. In high school I started heavy into sports and even though I was busting my butt I could never keep up and worn down easy. When I was sick breathing would be hard. I actually grew up thinking my chest was supposed to be sunk in I never noticed it until I was changing in the locker room and other noticed. I also used to get severe chest pains.

We finally looked into a solution when I failed my sports physical for cross country. That's when we found i had a severe case, my sternum was centimeters away from my spine and my heart was displaced and one lung slightly collapsed. I had the surgery and it took well over a year to be able to play sports again, but never contact sports. It's now eight years later and my chest is stil stiff. But I can breather easier and I'm not sick nearly as much. I never regained my running endurance back so it all depends what you want to get out of surgery. I still have the bar in they never took it out or told me to take it out. I will say it took a few years but I'm getting chest pains again, not as severe though so I'm dealing with it.

My advice, if it's not physically bothering you don't fix it!! This is no walk in the park surgery. If you can live with the way you look don't fix it. This is a major surgery.

Now I can't tell you what procedure I had, all I know is they compared it to open heart surgery but without touching the heart. I know I have a Titanium bar in me, I think it's the Ravitch Procedure but I have a very long verticle inscion down my chest. They broke my sternum and some ribs to reset it in the correct position. But I was a high schooler and all I cared about was being able to look better, not be sick, and play sports again. So I wasn't always listening.

Hope this gives some insight on my experience.
JustCurious
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Apr 9, 2009 @ 12:12 pm
I have a friend that had this surgery done Jan 2, 2009. It is now April 9, 2009 and he still complains of pain. I know that he goes to the gym regularly. Is this pain normal? It affects his work duties, at rare times he has to lift things that are of light weight, but the majority of his hours are spent in front of a computer. Could he still be in pain or am I to assume that he just doesn't want to work?
8 Year Post-Op pain
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Jul 24, 2009 @ 2:14 pm
My case sounds very similar to a lot of the comments here.
It wasn't until I was around 15 when I started to feel a difference, although I had been able to see one for a while. I had what was commonly known as pigeon chest, where the sternum was actually raised a bit and protruding from my chest. As a member of my high school track team I noticed breathing problems, slight pains, and shortness of breath was above normal. When I went to the doctor, I was told the chest deformity might be the cause of these slight heart palpitations, and that It could cause me problems down the line.
I found a surgeon who acted like this was standard practice and although I was slightly out of her age range 8-16 (I was now 19) It was decided that this would be the best solution. Immediately after coming out of the anesthesia my family and I noticed the extreme beating of my heart right through my skin as if the two were separated only by a thin piece of paper. When asked about this, the doctor said it was completely normal. It wasn't for another couple months, when the pain didn't seem to go away I started asking questions. The doctor became very hard to reach all of the sudden. She was short and distant when I did talk to her, almost realizing the mistake. She advised me that we wouldn't know anything for at least a year, which low and behold to me was when the statue of limitations would run out, releasing her of most liability.
Doctor's aren't always as we might like to believe they are. Like your mechanic, they too make mistakes and may try to cover them up.
I'm not writing this to warn you of crooked doctors although it is to be noted especially by some of the younger crowd on here looking for a cosmetic fix, but instead to share with you what my like is like now.
I have had three repair operations to fix this mistake. A standard &quot;bar&quot; procedure was not used in my case. She left me with whats called a flayed chest. The sternum not connected to the ribs by cartilage leaves two separated pieces which move freely of one another and cause me a significant amount of pain constantly. I have learned to sleep again over the years, and how to sit in cars.
I am by normal standards physically disabled, and still looking for a fix. I have juggled jobs, and school unsuccessfully up until now. I am on high doses of pain medicine and sleep very little. I write to inform the uninformed of what kind of complications and risk are involved in this surgery. My recommendation is to do a lot of research to find the very top doctor money can buy if you decide to undertake this surgery. This isn't a walk in the park. If the surgery is successful I would plan on being in bed for at least a couple months and expect serious pain. Good luck, and remember that if this is strictly cosmetic, it is probably not worth the risk. Besides, our differences are what set us apart and give us character.
Teresa
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Sep 2, 2009 @ 8:08 am
Our son is 14 and has sever PE. It is affecting his self esteem so badly. we live in Cape Town, South Africa where the medical aid don't pay for the Nuss procedure. Has anybody else been able to motivate for medical aid? The op sounds so scary and as parents we would prefer not to take the risk, but have to consider our son whose daily life is being affected.
Mars
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Oct 29, 2009 @ 4:16 pm
My fiance has the opposite of this, his chestbone goes outward and his rib cage sinks in. What is that called??? Please answer ASAP! artfartxxmars@yahoo.com
Noah
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Dec 11, 2009 @ 12:12 pm
I've had this problem since i was a teenager. I'm 34 now. I want to have the Nuss Procedure. Does anyone know of Doctors who do this on adults my age. I live in Washington DC but can travel if needed. Please email me - Thanks! bates.noah@gmail.com
Noah
Alan Andrade
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Dec 15, 2009 @ 6:18 pm
Hi,
i have Pectus excavatum and it goes in about one inch is that considered minor or severe and it hasn't effected me in any way such as sports and breathing and i don't want to go through all the surgeries ad pain just to make it normal if i doesn't effect my health thanks please reply
Julian
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Jan 4, 2010 @ 12:00 am
Hi I didnt really notice I was any different to my friends until my aunty asked my mother why she hadent taken me to the doctor about my chest when i was about 13.. i didnt know any different and I dont think my mother really gave a toss about anything, but to the point.. I am 26 now I have a depression that is about an inch deep, and all through my life I have had heart pains and palpatations, saw left arm, pain up the back of my neck, which is all related to the heart.. sometimes after I go sailboading for a day because i put stress on my chest holding up the sail board.. the next 3 days i can hardly move because my heart is so saw.. i often feel like i can never take deep enough breaths too. I have ben to a few doctors but they all say nothing is wrong with me.. so I think that it must be the sunken chest doing the pain... I live in Australia, Does anyone else have these symptoms with this disease? Im seriously thinking of having it fixed to see if my heart problems go away.
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Feb 19, 2010 @ 10:22 pm
Hello everyone, I am 49 years old and I have been,there done that except having my PE repaired. I just got out of the hospital yesterday 2/18/10 because I was shoveling snow, bending over to pick of the snow on the shovel. It restricted the blood flow in the front of my heart and I begain to have pain in my heart. I waited until the next day and while I was having physical therapy the pain in the middle of my shoulder blades and down my neck to my left arm increased to point that I passed out and had to be taken by ambulance to the hospital. My advice to all is to be very careful when doing anything that requires excessive bending in the forward position for long periods of time. If you are bending forward to do things and you begain to feel pain in the heart, stop and seek medical help to avoid a heart attack. It is a blessing to be able to write to you because I thought it was over for me. Also my two sons 11 and 14 years old are developing PE. At times when I discuss this with the doctor and my son's school district,I feel that they think this is all a pile of Bull S. PE is real and it's effects present life long chellanges.
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Feb 22, 2010 @ 8:20 pm
i was born with pectus but had the nuss procedure done when i was very young, i am 21 weeks pregnant now but my question is will i have any complications with my pregnancy due to my medical history with pectus??
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Mar 14, 2010 @ 10:22 pm
Can anyone tell me please where in NYC this operation is done? or at least a consultation? My sister needs the surgery and I am trying to find out whether there is smth in NY. Thanks
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Mar 16, 2010 @ 11:11 am
This has been by far the most informative page I have found through days of internet searching. My otherwise healthy daughter is being seen by a pediatric surgeon to see what our treatments for this can or will be and being that it is my baby I am researching and looking for answers exhaustively. This answered everything I was wanting to know before going to her surgeon with point specific questions in a few weeks.
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May 12, 2010 @ 12:12 pm
My son just had the Nuss procedure done at Mayo Clinic (May 2010). We are very happy with every aspect, including the initial evaluation, the surgery, the hospital follow-up, and recovery. My son is happier, even while in pain, than he has been for a while.
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May 30, 2010 @ 7:19 pm
I'm glad he's doing fine. What were the pre-op procedures? My son will be getting it done next week.
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Jul 18, 2010 @ 12:12 pm
i will be having the nuss procedure in about 2 weeks and i was wondering what i should expect the day of the surgery please let me know asap thanks :)

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