Introduction

Pectus excavatum is a congenital condition where the breastbone is sunken into the chest, creating a caved - in appearance. While mild cases may not cause significant health problems, they can still impact a person's self - esteem and quality of life. In New York City, there are several hospitals renowned for their expertise in treating pectus excavatum. This article will explore these hospitals, the services they offer, and the treatment options available for patients with mild pectus excavatum.

Understanding Mild Pectus Excavatum

What is Pectus Excavatum?

Pectus excavatum is a relatively common congenital deformity where several ribs and the sternum (breastbone) grow abnormally, resulting in a sunken or caved - in appearance of the chest. 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. Although its causes are not completely understood, it is believed to arise from excessive growth of the cartilage connecting the ribs to the breastbone, which pulls the sternum inward.

Symptoms of Mild Pectus Excavatum

In mild cases, individuals may not experience any physical symptoms related to pectus excavatum. However, some people may have chest pain, shortness of breath, especially during exertion, and a decreased ability to perform strenuous physical activities. There can also be negative psychosocial effects, particularly in children and teenagers, who may feel self - conscious about their appearance and avoid activities that expose the chest.

Diagnosis of Mild Pectus Excavatum

Multiple tools are used to diagnose pectus excavatum and gauge its extent:

• Visual examination of the chest: A doctor can often detect the sunken appearance of the chest just by looking at the patient.
• Auscultation: Analysis of sounds of the heart and chest to detect the condition's effect on heart and lung function.
• Electrocardiogram (ECG or EKG): This test records the electrical activity of the heart and can help identify any cardiac issues.
• Echocardiogram: A non - invasive test that takes a picture of the heart with sound waves to check for heart valve defects or other structural abnormalities.
• Pulmonary function testing: Involves breathing into a mouthpiece connected to an instrument that measures the amount of air breathed over a period of time, assessing lung capacity.
• Chest X - ray: Provides a basic view of the chest bones and lungs.
• CT - scan: Gives a more detailed view of the chest anatomy and can be 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).

Top Hospitals for Mild Pectus Excavatum in New York City

NYU Langone Health

NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for patients with pectus excavatum. They have a comprehensive approach to treatment, which includes a thorough evaluation of the patient's condition and the development of an individualized treatment plan. The hospital offers access to leading - edge research and treatment options, and patients can browse the list of providers who treat pectus excavatum and schedule an appointment online.

NewYork - Presbyterian/Columbia University Irving Medical Center

Dr. Lyall A. Gorenstein, who practices at NewYork - 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. The hospital has a reputation for providing high - quality surgical and non - surgical treatments for pectus excavatum patients. Their multidisciplinary approach involves collaboration between thoracic surgeons, cardiologists, pulmonologists, and other specialists to ensure the best possible outcomes for patients.

NewYork - Presbyterian Queens

The thoracic surgery program at NewYork - Presbyterian Queens is one of the most sophisticated minimally invasive thoracic surgery programs in the world. They offer the minimally invasive Nuss procedure for pectus excavatum, among other advanced surgical techniques. Their team of board - certified, highly trained surgeons provides outstanding patient - centered care that is less invasive and more effective. 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.

Mount Sinai - New York

Mount Sinai offers both open and closed (minimally invasive) surgical options for pectus excavatum repair. The open surgery involves making an incision across the front part of the chest, removing the deformed cartilage, repositioning the breastbone, and using a metal strut to hold it in place until it heals. The closed method, used mostly for children, involves making two small incisions on each side of the chest, inserting a curved steel bar under the breastbone to lift it, and leaving the bar in place for at least 2 years. The hospital also provides comprehensive pre - and post - operative care, including a detailed medical exam, necessary tests, and instructions for patients and their families.

Golisano Children's Hospital - Rochester NY - University of Rochester Medical Center

Although it is located in Rochester, it is a notable option for families in New York. The Center for Chest Wall Reconstruction at Golisano Children's Hospital specializes in the evaluation and treatment of pectus excavatum and other chest wall abnormalities. They take a multidisciplinary approach to the care of children, combining surgical expertise with the services of colleagues in pediatric anesthesiology, pediatric cardiology, pediatric pulmonology, pediatric radiology, pediatric plastic surgery, and specialists in physical and occupational therapy. The journey starts with an office consultation, where they assess the child's chest wall, determine the best course of treatment, and may order testing if needed. They also provide regular follow - up to evaluate the treatment plan.

Treatment Options for Mild Pectus Excavatum

Non - Surgical Treatments

• Vacuum Bell Therapy: This non - surgical option involves using a device that creates a vacuum over the chest, pulling the sunken breastbone outward. When paired with exercises and stretches, patients who choose this option typically see excellent results. For example, approximately 80% of patients may see an elevation greater than 1 cm within 3 months, approximately 20% may see complete correction within 6 months, and approximately 13.5% may see complete correction within 18 months.
• Physical Therapy: Physical therapy can help improve posture, strengthen the chest muscles, and potentially reduce the appearance of mild pectus excavatum. A physical therapist can design a customized exercise program that includes chest - opening exercises, breathing exercises, and strength - training exercises for the surrounding muscles.

Surgical Treatments

• Nuss Procedure: The minimally invasive Nuss procedure is performed under general anesthesia. Using video - assisted thoracoscopic surgery or VATS, a horizontal passage is created underneath the sternum through two small incisions in the side of the chest. A convex bar known as the Lorenz pectus bar is specially shaped to fit the individual’s anatomy, inserted through the passage, 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 it is removed as an outpatient procedure. Many adults have also undergone this procedure with good results.
• Modified Ravitch Repair: This procedure is also performed under general anesthesia. It involves making a horizontal incision, removing small pieces of deformed chest cartilage, and repositioning the protruding ribs and sternum. Titanium bars are secured to the ribs and sternum to support the repaired chest architecture. The bars currently used can remain permanently in place, avoiding the need for a second operation.

The decision between non - surgical and surgical treatments depends on several factors, including the severity of the pectus excavatum, the patient's age, overall health, and personal preferences.

Choosing the Right Hospital

Expertise of the Medical Team

Look for hospitals with a team of experienced surgeons, cardiologists, pulmonologists, and other specialists who have a track record of treating pectus excavatum. For example, at NYU Langone and NewYork - Presbyterian/Columbia University Irving Medical Center, the doctors are well - trained and have in - depth knowledge of the latest treatment techniques.

Range of Treatment Options

A good hospital should offer both non - surgical and surgical treatment options for mild pectus excavatum. Mount Sinai, for instance, provides a choice between open and minimally invasive surgical repairs, allowing patients to select the option that best suits their needs.

Patient - Centered Care

Consider hospitals that take a patient - centered approach, including providing personalized treatment plans, pre - and post - operative education, and emotional support. Golisano Children's Hospital focuses on the overall well - being of the child, involving multiple specialists and providing follow - up care to ensure the best possible outcomes.

Research and Innovation

Hospitals that are involved in research and innovation are more likely to offer the latest and most effective treatment options. Lurie Children's Hospital, for example, is researching new ways to image chest wall deformities that reduce the need for radiation - based imaging, which can be beneficial for patients.

Patient Experiences and Testimonials

While exact patient experiences and testimonials may vary, many patients who have undergone treatment for pectus excavatum at these hospitals report positive outcomes. Some patients note that the surgical teams were professional and caring, and that the post - operative recovery was managed well. Others mention the improvement in their self - esteem and quality of life after treatment. For example, in cases where the Nuss procedure was performed, patients often appreciate the minimally invasive nature of the surgery, which results in less pain and a quicker return to normal activities. Non - surgical patients who opted for vacuum bell therapy also share their stories of seeing visible improvements in the appearance of their chest over time.

Conclusion

In New York City, patients with mild pectus excavatum have access to a number of top - notch hospitals. Each hospital has its own strengths, whether it's the expertise of the medical team, the range of treatment options, patient - centered care, or involvement in research. NYU Langone Health, NewYork - Presbyterian/Columbia University Irving Medical Center, NewYork - Presbyterian Queens, Mount Sinai - New York, and Golisano Children's Hospital - Rochester NY - University of Rochester Medical Center are all excellent choices. The decision of which hospital to choose depends on individual factors such as the patient's age, the severity of the condition, and personal preferences.

If you or a loved one is dealing with mild pectus excavatum, take the time to research these hospitals, consult with their specialists, and make an informed decision. Remember, early diagnosis and appropriate treatment can lead to significant improvements in both physical health and quality of life. Don't hesitate to reach out to these medical institutions for more information and to start your journey towards better health.