Introduction
Pectus excavatum is a congenital deformity of the front of the chest wall that causes a sunken breastbone (sternum) and ribs. It is also called funnel or sunken chest and may worsen during the teen years. The condition can lead to physical symptoms such as chest pain, shortness of breath, and fatigue, as well as psychological effects like self - consciousness. Surgical correction is often an option for patients, especially those with severe cases. In New York City, there are several institutions that offer pectus excavatum correction surgery. This article will explore the ranking and share some cases related to these institutions.
Understanding Pectus Excavatum
Definition and Symptoms
Pectus excavatum is a condition where the breastbone (sternum) appears sunken and the chest concave. The majority of cases are isolated findings, but some are associated with genetic conditions. As the patient grows, especially during puberty, the deformity may become more prominent. In severe cases, it can shift the heart to the left side of the chest and compress the lungs, leading to limited lung capacity. Young children may not show symptoms, but teenagers often complain of shortness of breath with exertion, pain at the front of the chest, and early fatigue.
Diagnosis
Multiple tools are used to diagnose pectus excavatum and gauge its extent. These include visual examination of the chest, auscultation to analyze heart and chest sounds, electrocardiogram (ECG), echocardiogram, pulmonary function testing, chest x - ray, CT - scan, and the Haller index. The Haller index, calculated from a CT scan, measures the extent of the deformity. A Haller index greater than 3.25 is generally considered severe, while a normal index is around 2.5.
Types of Pectus Excavatum Correction Surgeries
Open Surgery
Open surgery is a more traditional approach. The surgeon makes a cut across the front part of the chest, removes the deformed cartilage while leaving the rib lining in place to allow for proper regrowth. A cut is then made in the breastbone, which is moved to the correct location. A metal strut may be used to hold the breastbone in place until it heals, which takes 3 to 12 months. A tube may be placed to drain fluids that build up in the repair area. The metal struts are removed in 6 to 12 months through a small cut in the skin under the arm, usually on an outpatient basis.
Closed (Minimally Invasive) Surgery
This method is mostly used for children. The surgeon makes two small incisions, one on each side of the chest. A small video camera called a thoracoscope is inserted through one of the incisions to view inside the chest. A curved steel bar, shaped to fit the child, is inserted through the incisions and placed under the breastbone to lift it. The bar is left in place for at least 2 years to help the breastbone grow properly. At the end of the surgery, the scope is removed and the incisions are closed. The Nuss procedure is a well - known minimally invasive technique.
Leading Institutions in New York City for Pectus Excavatum Correction Surgery
Mount Sinai - New York
Mount Sinai offers pectus excavatum repair surgeries. Their team of surgeons is experienced in both open and closed surgical methods. Before the surgery, patients undergo a complete medical exam and medical tests, including an electrocardiogram, echocardiogram, pulmonary function tests, and a CT scan or MRI of the chest. The hospital provides comprehensive pre - and post - operative care. For example, children usually stay in the hospital for 3 to 7 days after the surgery, and pain management is carefully monitored. Recovery and the overall success of the surgery are well - supported by the hospital's facilities and medical staff.
New York - Presbyterian / Columbia University Irving Medical Center
Dr. Lyall A. Gorenstein, a specialist in thoracic surgery at this institution, focuses on minimally invasive thoracic surgery, hyperhidrosis - palmar, and pectus excavatum. With his expertise, patients at New York - Presbyterian can expect high - quality surgical treatment. The hospital has state - of - the - art equipment and a multidisciplinary team that includes anesthesiologists, radiologists, and post - operative care nurses. This comprehensive approach ensures better surgical outcomes and patient satisfaction.
NYU Langone Health
NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for pectus excavatum patients. They offer a range of diagnostic and treatment options. The doctors work closely with patients and their families to develop an individualized treatment plan. Whether it is a mild or severe case of pectus excavatum, NYU Langone has the resources and expertise to address the problem effectively.
Patient Cases from New York City Institutions
Case 1: Mount Sinai - New York
A 14 - year - old boy came to Mount Sinai with a severe case of pectus excavatum. He had been experiencing shortness of breath during physical activities and was self - conscious about his appearance. After a thorough evaluation, including a CT scan that showed a high Haller index, the surgical team decided on a minimally invasive Nuss procedure. The surgery was successful, and the boy was able to leave the hospital within 5 days. During his recovery at home, he followed the pain management and activity restrictions as advised. After a few months, he noticed an improvement in his breathing and was more confident. By the time the bar was removed after 2 years, his chest had a more normal appearance, and he was able to participate in sports without shortness of breath.
Case 2: New York - Presbyterian / Columbia University Irving Medical Center
A 16 - year - old girl with pectus excavatum visited Dr. Lyall A. Gorenstein at New York - Presbyterian. She had a moderately severe deformity and was having chest pain. Dr. Gorenstein recommended a minimally invasive approach. The surgery was performed smoothly, and the girl received excellent post - operative care. The hospital's pain management team ensured that she was comfortable during her 4 - day hospital stay. As she recovered, she gradually returned to her normal activities. A year after the surgery, her chest pain had disappeared, and her chest looked much better.
Case 3: NYU Langone Health
A 13 - year - old boy with a family history of pectus excavatum was diagnosed with the condition at NYU Langone. His case was initially thought to be mild, but further evaluation showed some impact on his lung function. The doctors at NYU Langone decided on a combined approach, starting with a short - term course of non - surgical treatment and closely monitoring his condition. When it was determined that surgery was necessary, they performed a well - planned open surgery. The boy's recovery was carefully managed, and he was able to return to school within 3 weeks. After 6 months, his lung function had improved, and the appearance of his chest was significantly better.
Factors Affecting the Ranking of Institutions
Surgeon Expertise
The experience and skill of the surgeons play a crucial role in the ranking of institutions. Surgeons who have performed a large number of pectus excavatum correction surgeries, especially with successful outcomes, are highly sought after. For example, Dr. Barry Losasso, who has performed over 1,400 minimally invasive Nuss procedures, is well - recognized in the field. Institutions with such experienced surgeons are likely to rank higher.
Success Rates
The success rate of surgeries, including improvement in appearance, breathing, and reduction of symptoms, is a significant factor. Institutions that can demonstrate high success rates in correcting pectus excavatum and helping patients regain normal function are more likely to be highly ranked. This can be measured by patient follow - up, such as improved Haller index, better lung capacity, and patient satisfaction surveys.
Patient Care and Support
Comprehensive patient care from pre - operative evaluation to post - operative recovery is essential. Institutions that offer a multidisciplinary approach, including the involvement of cardiologists, pulmonologists, and pain management specialists, provide better care. Additionally, support services such as patient education, family counseling, and post - surgery rehabilitation programs contribute to a higher ranking.
Research and Innovation
Institutions that are involved in research and developing new surgical techniques or treatment methods are often ranked higher. For example, institutions that are exploring ways to reduce the recovery time, minimize pain, or improve the long - term outcomes of pectus excavatum correction surgery are more competitive in the field.
Comparative Table of New York City Institutions
| Institution | Surgeon Expertise | Success Rates | Patient Care and Support | Research and Innovation |
|---|---|---|---|---|
| Mount Sinai - New York | Experienced in open and closed surgeries, comprehensive pre - operative evaluation | High success in improving appearance and reducing symptoms, with long - term follow - up | Multidisciplinary team, 3 - 7 day hospital stay, pain management, post - operative guidance | Stays updated with the latest surgical techniques and participates in relevant medical research |
| New York - Presbyterian / Columbia University Irving Medical Center | Specialized surgeons like Dr. Lyall A. Gorenstein in minimally invasive techniques | Positive outcomes in terms of physical and psychological improvement | State - of - the - art facilities, comprehensive post - operative care, including pain management | Engages in research to improve surgical methods and patient outcomes |
| NYU Langone Health | Team of dedicated doctors offering personalized treatment plans | Good results in treating both mild and severe cases, with attention to long - term results | Multidisciplinary approach, patient and family support throughout the treatment process | Conducts research on new treatment options and patient - centered care |
Conclusion
In New York City, institutions like Mount Sinai - New York, New York - Presbyterian / Columbia University Irving Medical Center, and NYU Langone Health offer high - quality pectus excavatum correction surgeries. These institutions stand out due to their experienced surgeons, high success rates, comprehensive patient care, and involvement in research and innovation. Patient cases from these institutions demonstrate the positive impact of the surgeries on both physical health and psychological well - being. Whether it is a child or an adult with pectus excavatum, seeking treatment from a reputable institution in New York City can lead to significant improvement in their condition.
If you or someone you know is dealing with pectus excavatum, we encourage you to learn more about these institutions. Contact the hospitals directly to schedule a consultation and explore the treatment options available. Share this article with others who may benefit from this information, and help spread awareness about pectus excavatum correction surgery in New York City.
