Introduction
Pectus excavatum is a relatively common congenital deformity where the chest wall is sunken in, creating a caved - in appearance. This condition can affect lung capacity, cause fatigue, shortness of breath, chest pain, and a fast heartbeat, especially in severe cases. It also has potential negative psychosocial effects on children and teenagers. When considering surgical treatment for pectus excavatum in New York City, patients and their families need to make informed decisions based on reliable information. In this article, we will provide a comprehensive summary and evaluation of the top 5 hospitals for pectus excavatum surgery in New York City.
Understanding Pectus Excavatum
Definition and Causes
Pectus excavatum is a malformation of the chest wall in which several ribs and the sternum (breastbone) grow abnormally, resulting in a sunken appearance. It is believed to arise from excessive growth of the cartilage connecting the ribs to the breastbone, which pulls the sternum inward. Approximately 40% of people with pectus excavatum have one or more family members with the defect, indicating a possible genetic component.
Symptoms
- Often in mild cases, there may be no symptoms during ordinary activities. However, with rigorous exercise, symptoms such as fatigue, shortness of breath, chest pain, and a fast heartbeat may appear.
- In severe cases, the proximity of the sternum and the pulmonary artery may cause a heart murmur. Also, the condition can compromise lung and heart capacity.
- It can lead to poor posture, with slumped shoulders and a protruding abdomen. Psychosocial effects are common in children and teenagers, including self - consciousness and difficulty in peer interactions.
Diagnosis
Multiple tools are used to diagnose pectus excavatum and gauge its extent:
- Visual examination of the chest
- Auscultation - analysis of sounds of the heart and chest to detect the condition's effect on heart and lung function
- Electrocardiogram (ECG, also called EKG)
- Echocardiogram (a non - invasive test that takes a picture of the heart with sound waves)
- Pulmonary function testing (breathing into a mouthpiece connected to an instrument that measures the amount of air breathed over a period of time)
- Chest x - ray
- CT - scan
- Haller index: A measure of the extent of pectus excavatum by means of the CT scan. It is calculated by obtaining the ratio of the horizontal distance of the inside of the rib cage and the shortest distance between the vertebrae and sternum. A Haller index of greater than 3.25 is generally considered severe (a normal Haller index is 2.5).
Top 5 Hospitals for Pectus Excavatum Surgery in New York City
New York - Presbyterian Hospital - Columbia and Cornell
Expertise and Specialists
Dr. Lyall A. Gorenstein, affiliated with New York - Presbyterian / Columbia University Irving Medical Center, specializes in thoracic surgery, with a special focus on minimally invasive thoracic surgery, hyperhidrosis - palmar, and pectus excavatum. He is board - certified in surgery and thoracic surgery, having graduated from Canada in 1983 and completed his training at Univ Toronto Affil Hosp, UT MD Anderson Canc Ctr, and Univ Toronto Affil Hosp. This hospital is nationally ranked in 14 adult specialties and 10 pediatric specialties, which reflects its high - level expertise and comprehensive approach to patient care.
Treatment Options
They offer both the minimally invasive Nuss procedure and the modified Ravitch repair for pectus excavatum. The Nuss procedure is performed with general anesthesia using video - assisted thoracoscopic surgery (VATS). A convex bar is inserted under the sternum to push it outward, and the bar remains in place for at least three years. The modified Ravitch repair involves removing small pieces of deformed chest cartilage and repositioning the protruding ribs and sternum, with titanium bars secured to support the repaired chest architecture. The bars can remain permanently in place, avoiding the need for a second operation.
Outcomes and Patient Reviews
Given the hospital's national rankings and the experience of its surgeons, it is expected to have good surgical outcomes. However, specific patient reviews related to pectus excavatum surgery would need to be sourced from patient testimonials, online review platforms, or medical research. The long - standing reputation and wide range of specialties suggest that patients can expect high - quality pre - operative, operative, and post - operative care.
Mount Sinai Hospital
Expertise and Specialists
Mount Sinai Hospital has a team of experts capable of handling pectus excavatum cases. Although specific specialists are not as prominently mentioned as in some other institutions, the hospital's national ranking in 12 adult specialties and 4 pediatric specialties indicates its ability to provide comprehensive and high - quality care. The multi - disciplinary approach involving different medical specialties can contribute to better overall treatment outcomes.
Treatment Options
They offer two main types of surgery for pectus excavatum: open surgery and closed (minimally invasive) surgery. Open surgery involves making a cut across the front part of the chest, removing deformed cartilage, repositioning the breastbone, and using a metal strut for support. The metal struts are removed in 6 to 12 months. The closed method, mostly used for children, involves making two small incisions on each side of the chest, inserting a curved steel bar under the breastbone, and leaving it in place for at least 2 years.
Outcomes and Patient Reviews
Similar to New York - Presbyterian, the national ranking of Mount Sinai Hospital is a positive sign for patient outcomes. The variety of surgical options allows for a more personalized approach to treatment. Patient reviews can offer insights into the patient experience, pain management, and recovery process. Overall, the hospital's long - standing presence in the medical field and its high - performing status in multiple specialties give patients confidence in the quality of care.
NYU Langone Hospitals
Expertise and Specialists
NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for pectus excavatum. Although individual specialist details are not as elaborately presented as in some other hospitals, the hospital's national ranking in 13 adult specialties and 3 pediatric specialties suggests a high - level of expertise. The collaborative environment with different specialists can lead to a more well - rounded treatment plan.
Treatment Options
NYU Langone is likely to offer a range of surgical options similar to other top - tier hospitals, including minimally invasive procedures and open surgeries. The hospital may also incorporate the latest advancements in surgical techniques and post - operative care, taking into account the specific needs of each patient.
Outcomes and Patient Reviews
With its strong reputation in the medical community, NYU Langone is expected to have good surgical outcomes. Patient reviews can help to understand the patient - centered approach, communication with the medical team, and the overall satisfaction with the treatment process. The national recognition in multiple specialties indicates that patients can trust the hospital to provide high - quality care for pectus excavatum surgery.
North Shore University Hospital at Northwell Health
Expertise and Specialists
This hospital is nationally ranked in 9 adult specialties, which implies a high level of medical expertise. While there is limited specific information on pectus excavatum specialists, the hospital's overall standing suggests that it has the resources and skills to handle pectus excavatum cases. The multi - specialty environment allows for a comprehensive evaluation and treatment plan.
Treatment Options
North Shore University Hospital likely offers both minimally invasive and open surgical options for pectus excavatum. The surgical team would base the choice of procedure on the patient's age, the severity of the condition, and other individual factors. The hospital may also provide post - operative care programs to ensure a smooth recovery.
Outcomes and Patient Reviews
Based on its national ranking, North Shore University Hospital is expected to achieve favorable surgical outcomes. Patient reviews can provide valuable information on aspects such as the friendliness of the staff, the efficiency of the treatment process, and the long - term results of the surgery. The hospital's experience in multiple specialties can contribute to a more coordinated and effective treatment approach.
Lenox Hill Hospital at Northwell Health
Expertise and Specialists
Dr. Lawrence Bodenstein, a pediatric surgeon affiliated with Lenox Hill Hospital, is listed as a specialist in relevant fields. The hospital's national ranking in 10 adult specialties showcases its medical strength. The presence of experienced surgeons and a multi - specialty team can provide comprehensive care for pectus excavatum patients, especially considering the importance of a coordinated approach in treating congenital chest wall deformities.
Treatment Options
Lenox Hill Hospital offers treatment options similar to other top hospitals in the area, including both minimally invasive and open surgeries for pectus excavatum. The hospital may also focus on patient - centered care, tailoring the treatment plan to the specific needs and circumstances of each patient.
Outcomes and Patient Reviews
The national ranking of Lenox Hill Hospital is a positive indicator of its surgical outcomes. Patient reviews can offer insights into the patient experience, including the comfort of the hospital environment, the quality of pain management, and the follow - up care. The experience of the medical team and the hospital's reputation in multiple specialties suggest that patients can expect high - quality treatment for pectus excavatum.
Comparison of the Top 5 Hospitals
| Hospital | National Specialties Ranking | Well - Known Specialists | Treatment Options | Potential Advantages |
|---|---|---|---|---|
| New York - Presbyterian Hospital - Columbia and Cornell | 14 adult specialties and 10 pediatric specialties | Dr. Lyall A. Gorenstein | Nuss procedure, modified Ravitch repair | High - level expertise in multiple specialties, experienced specialist, bars in modified Ravitch can be permanent |
| Mount Sinai Hospital | 12 adult specialties and 4 pediatric specialties | - | Open surgery, closed (minimally invasive) surgery | Multiple surgical options, multi - disciplinary approach |
| NYU Langone Hospitals | 13 adult specialties and 3 pediatric specialties | - | Minimally invasive and open surgeries | Advanced and personalized care, collaborative environment |
| North Shore University Hospital at Northwell Health | 9 adult specialties | - | Minimally invasive and open surgeries | Multi - specialty resources, comprehensive evaluation |
| Lenox Hill Hospital at Northwell Health | 10 adult specialties | Dr. Lawrence Bodenstein | Minimally invasive and open surgeries | Experienced pediatric surgeon, patient - centered care |
Factors to Consider When Choosing a Hospital for Pectus Excavatum Surgery
Expertise of the Surgeons
The experience and expertise of the surgeons are crucial. Look for surgeons who specialize in pectus excavatum surgery, are board - certified, and have a track record of successful surgeries. Surgeons with more experience are likely to handle complex cases more effectively and achieve better outcomes.
Hospital Reputation and Rankings
National rankings and reputation of the hospital are important indicators of the quality of care. Hospitals with high rankings in relevant specialties are more likely to have advanced facilities, a multi - disciplinary team, and the latest treatment techniques.
Treatment Options Available
Consider the variety of treatment options offered by the hospital. Different patients may require different surgical approaches based on the severity of the condition, age, and other factors. A hospital that offers both minimally invasive and open surgeries can provide more flexibility in treatment.
Location and Accessibility
The location of the hospital is also a practical consideration. It should be easily accessible for pre - operative consultations, the surgery itself, and post - operative follow - up visits. Proximity to home can also be beneficial for family members who may need to accompany the patient.
Cost and Insurance Coverage
Understand the cost of the surgery and whether it is covered by your insurance. Different hospitals may have different pricing structures, and it is important to clarify the financial aspects before making a decision.
Recovery and After - Care
The recovery after pectus excavatum repair varies depending on the person’s age and the amount of chest depression. After surgery, most people leave the hospital within 3 to 5 days and can return to school or work within two to three weeks. However, one must avoid vigorous exercise for the first month after surgery and contact sports for three months after surgery.
Good after - care is essential for a successful recovery. This includes pain management, physical therapy, and regular follow - up visits with the surgeon. Some hospitals may offer comprehensive after - care programs, which can significantly improve the patient's recovery process and long - term outcomes.
Conclusion
When it comes to pectus excavatum surgery in New York City, the top 5 hospitals - New York - Presbyterian Hospital - Columbia and Cornell, Mount Sinai Hospital, NYU Langone Hospitals, North Shore University Hospital at Northwell Health, and Lenox Hill Hospital at Northwell Health - each have their own strengths and expertise. These hospitals offer a range of treatment options, have experienced medical teams, and are nationally recognized for their quality of care. When choosing a hospital, patients and their families should consider factors such as the expertise of the surgeons, hospital reputation, treatment options, location, and cost.
If you or a loved one is considering pectus excavatum surgery, we encourage you to research further, consult with the medical teams at these hospitals, and make an informed decision. You can also share this article with others who may benefit from this information, or explore related topics on pectus excavatum treatment and care.
