Introduction

Pectus excavatum is a congenital deformity of the front of the chest wall that causes a sunken breastbone and ribs, also known as funnel or sunken chest. It may worsen during the teen years and can lead to chest pain and affect breathing, especially in adults. Surgical repair is often an option for patients, and in New York City, there are several top - notch hospitals equipped to handle adult pectus excavatum surgery. In this article, we will reveal the names of the top three hospitals for this specific surgery, along with detailed information about the condition, the surgical procedures, and what makes these hospitals stand out.

Understanding Pectus Excavatum

Definition and Causes

Pectus excavatum is a condition where the breastbone (sternum) appears sunken and the chest is concave. While the exact cause is often unknown, it is believed to be related to abnormal growth of the cartilage that connects the ribs to the sternum. Some genetic conditions may also be associated with pectus excavatum, though the majority of cases are isolated findings (Mount Sinai - New York).

Symptoms

Many patients with pectus excavatum may have few or no symptoms initially. However, as the condition progresses, especially in adulthood, symptoms can include chest pain, shortness of breath, especially during physical activity, a rapid heartbeat, and a decreased ability to exercise. Some patients may also experience psychological distress due to the appearance of their chest (Mount Sinai - New York).

Diagnosis

A physical examination by a healthcare provider is often the first step in diagnosing pectus excavatum. This may involve observing the shape of the chest and feeling for any abnormalities. Further diagnostic tests may include an electrocardiogram (ECG) to check the heart's function, pulmonary function tests to assess breathing ability, and a CT scan or MRI of the chest to get a detailed view of the chest structure (Mount Sinai - New York).

Pectus Excavatum Surgery

Types of Surgery

There are two main types of surgery to repair pectus excavatum: open surgery and closed (minimally invasive) surgery.

• Open Surgery: This is a more traditional approach. The surgeon makes an incision across the front part of the chest, removes the deformed cartilage while leaving the rib lining intact to allow for correct cartilage regrowth. A cut is then made in the breastbone, which is moved to the correct location, and a metal strut may be used to hold it in place until it heals. Healing can take 3 to 12 months. The metal struts are usually removed in 6 to 12 months through a small cut under the arm on an outpatient basis. A tube may be placed to drain fluids from the repair area.
• Closed (Minimally Invasive) Surgery: This method is mostly used for children but can also be an option for adults. No cartilage or bone is removed. The surgeon makes two small incisions on each side of the chest and inserts a small video camera (thoracoscope) through one of the incisions to view inside the chest. A curved steel bar shaped to fit the patient is then inserted under the breastbone to lift it. The bar is left in place for at least 2 years to help the breastbone grow properly. The surgery can take 1 to 4 hours depending on the procedure (Mount Sinai - New York).

Surgery Risks

As with any surgery, pectus excavatum repair comes with risks. General risks of anesthesia and surgery include reactions to medicines, breathing problems, bleeding, blood clots, and infection. Specific risks for this surgery include injury to the heart, lung collapse, pain, and the return of the deformity. Older patients may have a higher risk of complications compared to younger patients. For example, a study found that the rates of any postoperative complication differed by age, with 12 - 17 years having a 30.6% rate, 18 - 29 years having a 45.2% rate, and 30+ years having a 62.1% rate (National trends in pectus excavatum repair).

Pre - and Post - operative Care

Before the surgery, a complete medical exam and various medical tests are required. Patients need to inform the surgeon about all the medicines they are taking, including over - the - counter drugs, herbs, and supplements, as well as any allergies. About 7 days before surgery, some blood - thinning drugs may need to be stopped. On the day of surgery, patients are usually asked not to eat or drink after midnight. After the surgery, it is common for patients to stay in the hospital for 3 to 7 days. Pain management is crucial, and patients may receive strong pain medicine initially, followed by oral medicines. They will also have tubes in the chest to drain extra fluid, which will be removed when the drainage stops. Early mobilization, such as sitting up, taking deep breaths, and walking, is encouraged to aid in healing (Mount Sinai - New York).

Top Three Hospitals for Adult Pectus Excavatum Surgery in New York City

1. New York - Presbyterian Hospital - Columbia and Cornell

Reputation and Ranking

New York - Presbyterian Hospital - Columbia and Cornell is one of the top - ranked hospitals in New York. It is nationally ranked in 14 adult specialties and 10 pediatric specialties according to U.S. News Best Hospitals. This hospital's comprehensive approach to patient care, combined with its world - class medical research and education, makes it a prime choice for complex surgeries like adult pectus excavatum repair. Its high - performing status in multiple procedures and conditions reflects the quality of care provided by its medical staff.

Expertise in Pectus Excavatum Surgery

The hospital has a team of highly skilled surgeons and medical professionals who are experienced in treating pectus excavatum. For example, it is affiliated with experts like Dr. Lyall A. Gorenstein, who specializes in thoracic surgery with a focus on minimally invasive thoracic surgery and pectus excavatum. The hospital likely offers both open and minimally invasive surgical options for pectus excavatum repair, and its advanced facilities and technology ensure accurate diagnosis and optimal surgical outcomes.

Research and Innovation

New York - Presbyterian Hospital - Columbia and Cornell is at the forefront of medical research. In the field of pectus excavatum surgery, this means that patients may benefit from the latest surgical techniques and treatment protocols. The hospital's research efforts can lead to improvements in surgical outcomes, reduced complication rates, and enhanced patient recovery. For instance, ongoing research may focus on better understanding the long - term effects of different surgical approaches and how to personalize treatment for adult patients.

2. NYU Langone Hospitals

Reputation and Ranking

NYU Langone Hospitals is also a top - tier hospital in New York City. It is nationally ranked in 13 adult specialties and 3 pediatric specialties, according to U.S. News Best Hospitals. The hospital's commitment to providing the most advanced, personalized care is evident in its rankings and the high - quality medical services it offers. Its status as a high - performing hospital in multiple procedures and conditions makes it a reliable choice for adult pectus excavatum surgery.

Expertise in Pectus Excavatum Surgery

NYU Langone has a dedicated team of doctors who treat pectus excavatum. The hospital's doctors are well - versed in the latest surgical techniques for pectus excavatum repair. They can assess each patient's unique condition and recommend the most appropriate treatment option. Whether it is a minimally invasive approach for a patient with a less severe deformity or an open surgery for a more complex case, NYU Langone has the expertise to handle it. The hospital also provides comprehensive pre - and post - operative care to ensure a smooth recovery for patients.

Patient - centered Approach

One of the strengths of NYU Langone is its patient - centered approach. The medical staff takes the time to understand the patient's concerns, goals, and expectations. This personalized approach helps patients feel more comfortable and informed throughout the treatment process. For example, they may offer support groups or counseling services for patients dealing with the psychological impact of pectus excavatum. Additionally, the hospital's multidisciplinary team, which may include surgeons, cardiologists, and pulmonologists, works together to provide coordinated care for each patient.

3. Mount Sinai Hospital

Reputation and Ranking

Mount Sinai Hospital is nationally ranked in 12 adult specialties and 4 pediatric specialties. It is recognized as one of the best hospitals in New York by U.S. News Best Hospitals. The hospital's high - performance in various medical fields, including thoracic surgery, makes it a suitable option for adult pectus excavatum surgery. Its reputation for excellence in patient care and medical research adds to its appeal for patients seeking treatment for this condition.

Expertise in Pectus Excavatum Surgery

Mount Sinai has detailed information available about pectus excavatum repair, including the surgical procedures, risks, and pre - and post - operative care. This indicates that the hospital has a wealth of knowledge and experience in treating this condition. The surgeons at Mount Sinai are likely well - trained in performing both open and minimally invasive pectus excavatum surgeries. They can use advanced imaging techniques to accurately assess the patient's chest structure and plan the surgery accordingly.

Research and Clinical Trials

Mount Sinai is actively involved in medical research and may conduct clinical trials related to pectus excavatum surgery. Participating in clinical trials can give patients access to new and experimental treatments that may not be available elsewhere. For example, a clinical trial could test a new surgical device or technique that has the potential to improve surgical outcomes and reduce recovery time. This research - driven approach ensures that patients at Mount Sinai receive the most up - to - date and effective treatment for pectus excavatum.

Comparing the Three Hospitals

Factors to Consider When Choosing a Hospital for Pectus Excavatum Surgery

Hospital Reputation and Ranking

As seen from the above - mentioned hospitals, a high national ranking and good reputation are important indicators of the quality of care. A hospital that is nationally recognized in relevant specialties is more likely to have experienced surgeons, advanced facilities, and high - quality medical staff. U.S. News Best Hospitals provides a reliable source of information on hospital rankings, which can help patients make an informed decision.

Surgeon Experience

The experience of the surgeon performing the pectus excavatum surgery is crucial. Patients should look for surgeons who have a significant amount of experience in treating pectus excavatum, especially in adults. They can ask about the number of surgeries the surgeon has performed, the success rates, and any complications they have encountered. Some hospitals may have surgeons who specialize in minimally invasive techniques, which can lead to less pain and a shorter recovery time.

Hospital Facilities and Technology

Advanced hospital facilities and technology are essential for accurate diagnosis and successful surgery. A hospital with state - of - the - art imaging equipment, such as CT scanners and MRIs, can provide detailed information about the patient's chest structure. This helps the surgeon plan the surgery more effectively. Additionally, the availability of advanced surgical equipment and a well - equipped operating room can contribute to better surgical outcomes.

Patient Reviews and Testimonials

Reading patient reviews and testimonials can give potential patients an idea of what to expect at a particular hospital. Patients can look for reviews on hospital websites, online review platforms, or patient advocacy groups. Positive reviews about the surgical experience, pre - and post - operative care, and the attitude of the medical staff can be reassuring. On the other hand, negative reviews can highlight potential issues that patients should consider.

Cost and Insurance Coverage

The cost of pectus excavatum surgery can vary depending on the hospital, the type of surgery, and the length of the hospital stay. Patients should check with their insurance providers to see which hospitals are in - network and what their coverage options are. Some hospitals may offer financial assistance programs or payment plans to help patients manage the cost of the surgery. It is important to have a clear understanding of the financial aspects before making a decision.

Conclusion

In conclusion, adult pectus excavatum surgery is a complex procedure that requires the expertise of a skilled surgical team and the resources of a top - quality hospital. New York - Presbyterian Hospital - Columbia and Cornell, NYU Langone Hospitals, and Mount Sinai Hospital are the top three hospitals in New York City for this type of surgery. These hospitals offer high - quality medical care, experienced surgeons, advanced technology, and a patient - centered approach. However, patients should carefully consider various factors, such as hospital reputation, surgeon experience, facilities, and cost, before choosing a hospital for their pectus excavatum surgery.

If you or someone you know is considering pectus excavatum surgery, we encourage you to do further research, consult with medical professionals, and make an informed decision. Share this article with others who may benefit from this information, and explore more about pectus excavatum and other medical topics on our website.