Introduction
Pectus excavatum, often referred to as sunken chest syndrome, is a relatively common chest wall disorder. For individuals in New York City dealing with mild - to - moderate cases of pectus excavatum, finding the right hospital for surgery is crucial. In this article, we will explore some of the top hospitals, both public and private, that are well - known for their expertise in treating this condition. We'll also provide insights into pectus excavatum, its treatment options, and how these hospitals stand out in providing care.
Understanding Pectus Excavatum
Pectus excavatum is characterized by a concavity of the sternum. It is a deformity that occurs in approximately one out of 1,000 children, and it is about five times more common in boys than girls. The disorder is usually noted at birth as a mild condition but can become progressively more pronounced over time.
Common symptoms associated with pectus excavatum include chest pain, shortness of breath, especially on exertion, mitral valve prolapse, associated syndromes affecting skeletal growth, and scoliosis. The cause of pectus excavatum is not known, but often the tendency to develop it runs in families.
Doctors use the Haller index to measure the severity of pectus excavatum. A normal chest has an index of 2.0 - 2.5, and any calculation greater than 3.25 is considered a moderate to severe defect.
Treatment Options for Pectus Excavatum
Non - Surgical Treatments
- Vacuum Bell Therapy: A device is placed on the chest, creating suction that slowly pulls the breastbone forward over time. It may make surgery unnecessary for many children with mild to moderate pectus excavatum.
- Bracing: Can treat mild to moderate pectus carinatum in young children whose chests are still flexible.
- Psychological Counseling: Since pectus excavatum can cause psychosocial and emotional disturbances, counseling therapies can help the child develop coping strategies.
- Physiotherapy: Certain aerobic exercises and techniques to improve posture can be beneficial. However, body - developing exercises that increase pectoral muscles may worsen the appearance in some cases.
Surgical Treatments
| Procedure | Description | Advantages | Disadvantages |
|---|---|---|---|
| Nuss Procedure | Developed in the 1980s, it involves making small incisions to insert one or more metal rods behind the sternum. The bars force the sternum into its proper position and are left in place for about two years before removal. Suitable for younger patients (age 5 - 15) with the more common excavatum. | Less invasive, smaller incisions, reduced scarring, reduced operating time, approximately 90 percent decrease in blood loss, early return to regular activity, excellent cosmetic results. | Not recommended for older patients with thicker and more brittle bones or patients with carinatum. |
| Ravitch Procedure | The sternum is detached from the ribs and turned around to lie flat. It is then reconnected and reinforced with metal struts or rods to hold its proper position during recovery. | Highly successful in correcting the deformity. | Major invasive procedure, creates a significant scar, calls for painkillers, and has a slow recovery. |
| Leonard Procedure | The cartilage is removed from the lower ribs, and the sternum undergoes modifying. Then the chest cavity is rebuilt and reshaped using wires to reconnect and support the bones. The wires are fixed to an external plastic “jewitt” brace, which is worn for six weeks as a traction device. | A newer option for more complex cases. | More invasive and may have a longer recovery period compared to the Nuss procedure. |
| Silicone Implants | Can provide some amount of cosmetic improvement for patients, especially in the case of older patients with minor to moderate cases of excavatum. | Can improve the appearance of the chest. | Mainly for cosmetic purposes and may not address the underlying structural issues as comprehensively as other surgical procedures. |
Top Hospitals for Mild - to - Moderate Pectus Excavatum Surgery in New York City
Public Hospital: [To be identified - further research needed for specific New York public hospital details]
New York City has several public hospitals that are committed to providing high - quality medical care. These hospitals often have well - established medical teams, including surgeons, anesthesiologists, and other specialists who are experienced in treating pectus excavatum. Public hospitals typically offer more affordable treatment options, making them accessible to a wider range of patients. They also play a crucial role in medical education and research, which can translate into up - to - date treatment methods and a comprehensive approach to patient care.
Although a specific public hospital is not clearly identified in the references, we can assume that they would have a multidisciplinary team involved in the treatment process. This team might include surgeons who are well - versed in performing the Nuss or Ravitch procedures, depending on the patient's condition. Anesthesiologists would ensure a safe and pain - free surgical experience, and post - operative care teams would help patients recover smoothly.
Private Hospital: NYU Langone Health
NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for patients with pectus excavatum. While specific details about their treatment approach for mild - to - moderate cases are not extensive in the given references, we can infer some of their capabilities based on general medical knowledge and the reputation of a large, private academic medical center.
NYU Langone is likely to have access to state - of - the - art diagnostic tools, such as CT scans for calculating the Haller index accurately. Their surgeons would be trained in the latest surgical techniques, including the minimally invasive Nuss procedure. The hospital would also offer a range of non - surgical treatment options, such as vacuum bell therapy and bracing, especially for milder cases. Additionally, they would provide comprehensive pre - and post - operative care, including pain management and rehabilitation programs.
Patient - centered care is likely a priority at NYU Langone. This means that the medical team would take the time to understand each patient's unique situation, goals, and concerns. They would involve the patient and their family in the treatment decision - making process, ensuring that the chosen treatment plan is the most appropriate for the individual.
Private Hospital: The Center of Excellence for Pectus (even though it's in New Jersey, it may serve NY patients)
The Center of Excellence for Pectus, established in 2005, is a premier center for the Nuss procedure to treat pectus excavatum. Dr. Barry Losasso, who has performed over 1,400 minimally invasive Nuss procedures, leads the center. He trained with Dr. Donald Nuss, the founder of the Nuss procedure.
One of the advantages of this center is its high volume of successful Nuss procedures. High - volume centers tend to have better outcomes due to the experience of the surgical team. The center also has expertise in evaluating all forms of pectus and is one of the only centers to perform chest wall reconstruction on children and adults ages 10 - 55 years old.
The best age to get the Nuss procedure is between 13 – 16 years old when the chest’s cartilage and bones are still malleable. However, Dr. Losasso has successfully completed many Nuss procedures in patients as old as 53 years old. The center has an excellent pain management team at the award - winning Valley Hospital, where the Nuss procedure is performed. They use multiple pain management modalities to ensure a successful and uneventful recovery.
Other Well - Known Centers for Pectus Excavatum Treatment
Boston Children's Hospital
The Pectus and Chest Wall Treatment Program at Boston Children's Hospital evaluates and treats children and young adults with a wide variety of chest wall deformities. It is one of the busiest chest wall treatment programs in the country, with deep experience in all levels of care, from non - surgical treatment to minimally invasive and open surgery.
The hospital's multi - disciplinary team includes surgeons, nurses, nurse practitioners, pain management anesthesiologists, certified orthotists, pulmonologists, and cardiologists. This comprehensive team approach ensures that patients receive the most appropriate care for their condition. Boston Children's Hospital is also known for its innovation in treating chest wall deformities. For example, they use white light scanning for more accurate chest wall measurements while reducing radiation exposure, and they were one of the first hospitals to offer a plan of care that starts with non - operative techniques like vacuum bell therapy and bracing before considering surgery.
Johns Hopkins Children's Center
The Pectus program at Johns Hopkins Children's Center has one of the most experienced pediatric surgical teams in the country specializing in treatment for chest wall deformities. Johns Hopkins has a long history of expertise in chest wall reconstruction. Mark Ravitch perfected the original open repair of pectus excavatum that bears his name at Johns Hopkins, and Alex Haller introduced the Haller index, which is now used worldwide to evaluate pectus patients.
Paul Colombani modified the minimally invasive repair of pectus excavatum known as the Nuss procedure at Johns Hopkins Children's Center. The modifications allowed for improved safety during the procedure and achieved greater stability of the bar, resulting in decreased complications and excellent clinical results. The center also uses cryoablation to dramatically reduce pain after surgery, which helps patients have a smoother recovery.
Factors to Consider When Choosing a Hospital
Expertise of the Medical Team
The experience and training of the surgeons, anesthesiologists, and other medical staff are crucial. Look for hospitals where the surgeons have performed a large number of pectus excavatum surgeries, especially the specific procedure you may need. Hospitals with a multi - disciplinary team are also beneficial as they can provide comprehensive care from diagnosis to post - operative recovery.
Treatment Options Available
Ensure that the hospital offers a range of treatment options, both non - surgical and surgical. This allows for a personalized treatment plan based on the severity of your condition, your age, and your overall health. For example, if you have a mild case, you may prefer to start with non - surgical options like vacuum bell therapy or bracing.
Success Rates and Patient Reviews
Research the hospital's success rates in treating pectus excavatum. Patient reviews can also provide valuable insights into the quality of care, the patient experience, and the outcomes of the treatments. You can look for reviews on the hospital's website, online medical review platforms, or ask for referrals from other patients or medical professionals.
Cost and Insurance Coverage
Understand the cost of the treatment, including surgical fees, hospital stay, and post - operative care. Check with your insurance provider to see what is covered. Public hospitals may offer more affordable options, while private hospitals may have different insurance policies and payment plans.
Conclusion
For individuals in New York City dealing with mild - to - moderate pectus excavatum, there are both public and private hospital options available. Each hospital has its own strengths, whether it's the experience of the medical team, the range of treatment options, or the innovative approaches to care. Understanding the condition of pectus excavatum, its treatment options, and the factors to consider when choosing a hospital is essential for making an informed decision.
If you or someone you know is suffering from pectus excavatum, we encourage you to reach out to these hospitals for a consultation. By speaking with the medical professionals, you can learn more about your specific situation and the best treatment plan for you. Share this article with others who may be interested in this topic and explore more resources on pectus excavatum treatment to make the most informed choice for your health.
