Introduction
Pectus excavatum, a congenital chest wall deformity where the breastbone is sunken into the chest, can have both physical and psychological impacts on patients. It may cause breathing difficulties, reduced exercise tolerance, and self - consciousness. In New York City, several hospitals offer advanced treatment options for pectus excavatum correction. This article will explore the top three hospitals known for their expertise in this area.
What is Pectus Excavatum?
Pectus excavatum is a relatively common congenital deformity where several ribs and the sternum (breastbone) grow abnormally, resulting in a caved - in or sunken appearance. It occurs more often in males than in females, and approximately 40% of people with pectus excavatum have one or more family members with the defect. The condition can range from mild to severe and may become more pronounced during puberty. Severe cases can affect lung capacity, causing fatigue, shortness of breath, chest pain, and a fast heartbeat.
Diagnosis of Pectus Excavatum
Doctors use multiple tools to diagnose pectus excavatum and gauge its extent:
- Visual examination of the chest: A simple yet initial step to identify the sunken appearance of the chest wall.
- Auscultation: Analysis of sounds of the heart and chest to detect the condition's effect on heart and lung function.
- Electrocardiogram (ECG or EKG): To check the electrical activity of the heart and detect any abnormalities related to the chest deformity.
- Echocardiogram: A non - invasive test that takes a picture of the heart with sound waves, assessing anatomical variables such as heart valve defects.
- Pulmonary function testing: Involves breathing into a mouthpiece connected to an instrument that measures the amount of air breathed over a period of time, helping to determine the impact on lung capacity.
- Chest X - ray: Provides a basic view of the chest structure.
- CT - scan: Offers detailed images of the chest and is used to calculate the Haller index, a measure of the extent of pectus excavatum. A Haller index of greater than 3.25 is generally considered severe (a normal Haller index is 2.5).
Treatment Options for Pectus Excavatum
There are mainly two types of surgical treatments for pectus excavatum:
Open Surgery (Modified Ravitch Repair)
This 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 the cartilage to grow back correctly. 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 the normal position until it heals, which takes 3 to 12 months. The metal struts are removed in 6 to 12 months through a small cut in the skin under the arm. This procedure is usually done on an outpatient basis.
Closed (Minimally Invasive) Surgery (Nuss Procedure)
This 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 placed 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.
Top Three Hospitals for Pectus Excavatum Correction in New York City
Columbia University's Surgical Lung & Chest Care Program
Overview
As part of Columbia University Irving Medical Center and New York - Presbyterian, this program is consistently named one of New York's top hospitals and one of the top ten medical centers in the nation. It provides up - to - date options for all chest conditions, including pectus excavatum.
Expertise in Pectus Excavatum
Columbia offers both the minimally invasive Nuss procedure and the modified Ravitch repair for pectus excavatum. The ideal age for surgical treatment at Columbia is between 12 and 18 years. The goal of surgery is to improve breathing, posture, and cardiac function, in addition to giving the chest a normal appearance. The surgical repair has excellent success rates, and in the majority of cases, cardiovascular and lung function return to near normal.
During the Nuss procedure, which is performed with general anesthesia using video - assisted thoracoscopic surgery (VATS), a convex bar known as the Lorenz pectus bar is specially shaped to fit the individual’s anatomy, inserted through a horizontal passage underneath the sternum created via two small incisions in the side of the chest, and then turned to push the sternum outward. The bar must remain in place for a minimum of three years while the chest contour re - forms to its new shape and is removed as an outpatient procedure. The modified Ravitch repair, also performed under general anesthesia, involves removing small pieces of deformed chest cartilage and repositioning the protruding ribs and sternum, with titanium bars secured to the ribs and sternum to support the repaired chest architecture. The current bars can remain permanently in place, avoiding the need for a second operation.
Patient Experience and Outcomes
After pectus excavatum repair at Columbia, most people leave the hospital within 3 to 5 days and can return to school or work within two to three weeks. However, they must avoid vigorous exercise for the first month after surgery and contact sports for three months after surgery.
Contact Information
Existing patients can call (212) 305 - 3408, and new patients can call (212) 304 - 7535. The program is located at the Herbert Irving Pavilion, 161 Fort Washington Avenue, 3rd floor, New York, New York 10032. It also has other locations in New Jersey.
NewYork - Presbyterian Queens
Overview
NewYork - Presbyterian Queens has a highly sophisticated minimally invasive thoracic surgery program. It has earned a three - star rating from the Society of Thoracic Surgeons (STS) for patient care and outcomes in isolated coronary artery bypass grafting (CABG) procedures, placing it among the elite for heart bypass surgery in the United States and Canada.
Expertise in Pectus Excavatum
The hospital offers the minimally invasive Nuss procedure for pectus excavatum correction. The thoracic surgeons at NewYork - Presbyterian Queens, in collaboration with Weill Cornell Medicine, provide the latest in surgical techniques and comprehensive care. The multidisciplinary team, including thoracic surgeons, medical and radiation oncologists, pulmonologists, gastroenterologists, radiologists, pathologists, neurologists, physician assistants, nurse practitioners, dedicated thoracic intensive care nurses, respiratory therapists, speech therapists, and social workers, collaborates to deliver seamless, high - quality care to patients before, during, and after their hospital stay.
Patient Experience and Outcomes
The majority of patients are able to have their surgery performed through a minimally invasive approach, which results in less blood loss, less postoperative pain, shorter hospital stays, and a quicker recovery and return to normal activities. A minimally invasive approach is also a surgical treatment option for many elderly and very ill patients who are not able to tolerate conventional open surgery.
Contact Information
The Division of Thoracic Surgery at NewYork - Presbyterian Queens is located at 56 - 45 Main Street, Flushing, NY 11355. The contact number is 718 - 670 - 2707.
NYU Langone Health
Overview
NYU Langone Health is well - known for its comprehensive medical services. The team of doctors at NYU Langone is dedicated to providing the most advanced, personalized care for various medical conditions, including pectus excavatum.
Expertise in Pectus Excavatum
While specific details about their treatment techniques are not as fully elaborated as in the other hospitals in the available information, NYU Langone offers a range of medical expertise related to chest conditions. Their doctors are likely to use state - of - the - art diagnostic and treatment methods, possibly including the Nuss procedure and the modified Ravitch repair, similar to the other leading hospitals in the area.
Patient Experience and Outcomes
Patients can expect personalized care from a team of experts at NYU Langone. The hospital's reputation for quality medical care suggests that patients are likely to receive high - level treatment and support throughout their pectus excavatum correction journey.
Contact Information
Patients can browse the list of providers who treat pectus excavatum on the NYU Langone website and schedule an appointment online. The website link is https://nyulangone.org/doctors/condition/pectus-excavatum.
Comparison of the Three Hospitals
| Hospital | Overall Reputation | Treatment Techniques | Patient Experience | Contact Information |
|---|---|---|---|---|
| Columbia University's Surgical Lung & Chest Care Program | One of New York's top hospitals and top ten in the nation | Nuss procedure and modified Ravitch repair | Short hospital stay, relatively quick return to normal activities with clear post - op guidelines | Existing patients: (212) 305 - 3408; New patients: (212) 304 - 7535; Herbert Irving Pavilion, 161 Fort Washington Avenue, 3rd floor, New York, NY 10032 |
| NewYork - Presbyterian Queens | Three - star rating from STS for CABG procedures, elite in heart bypass surgery | Minimally invasive Nuss procedure | Minimally invasive approach with less blood loss, pain, and shorter stays, suitable for some high - risk patients | Division of Thoracic Surgery, 56 - 45 Main Street, Flushing, NY 11355; 718 - 670 - 2707 |
| NYU Langone Health | Well - known for comprehensive medical services | Likely to offer Nuss procedure and modified Ravitch repair | Personalized care from a team of experts | Online appointment scheduling via https://nyulangone.org/doctors/condition/pectus-excavatum |
Conclusion
When it comes to pectus excavatum correction in New York City, Columbia University's Surgical Lung & Chest Care Program, NewYork - Presbyterian Queens, and NYU Langone Health stand out as top choices. Each hospital brings its own unique strengths, whether it's the national reputation and advanced treatment options at Columbia, the minimally invasive expertise and excellent patient outcomes at NewYork - Presbyterian Queens, or the comprehensive and personalized care at NYU Langone. If you or a loved one is suffering from pectus excavatum, it is advisable to consult with the experts at these hospitals to determine the most suitable treatment plan. Don't let this condition affect your quality of life any longer. Reach out to these hospitals, explore your options, and take the first step towards a better - shaped chest and improved well - being.
