Introduction

Pectus excavatum is a relatively common congenital deformity where the chest wall is sunken in, creating a caved - in appearance. This condition can range from mild to severe, and in severe cases, it may affect lung capacity, cause fatigue, shortness of breath, chest pain, and a fast heartbeat. For those seeking treatment for pectus excavatum in New York City, there are several excellent hospitals. In this article, we will explore the top 3 hospitals known for their expertise in pectus excavatum correction.

What is Pectus Excavatum?

Pectus excavatum is a malformation of the chest wall in which several ribs and the sternum (breastbone) grow abnormally. It is more common in males than in females, and approximately 40% of people with this condition have one or more family members with the defect. The condition can be present at birth or may develop during puberty. The causes of pectus excavatum are not completely understood, but it is believed to arise from excessive growth of the cartilage connecting the ribs to the breastbone, which pulls the sternum inward. When it comes to symptoms, mild cases may not cause any significant problems, but severe cases can have a profound impact on a person's health. The following table summarizes the common symptoms associated with pectus excavatum:

Symptom	Description
Fatigue	Due to the reduced lung capacity, the body has to work harder to get enough oxygen, leading to fatigue.
Shortness of breath	The lungs are confined and cannot properly expand, making it difficult to breathe, especially during physical activity.
Chest pain	May be caused by the pressure on the heart and lungs due to the sunken chest.
Fast heartbeat	The heart has to work harder to pump blood effectively in the restricted chest space.
Heart murmur	In some cases, the proximity of the sternum and the pulmonary artery may cause a heart murmur.

Diagnostic Tools for Pectus Excavatum

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

1. Visual examination of the chest: A doctor can often detect the sunken appearance of the chest during a physical examination.
2. Auscultation: Analysis of sounds of the heart and chest to detect the condition's effect on heart and lung function.
3. Electrocardiogram (ECG, also called EKG): Helps to evaluate the heart's electrical activity.
4. Echocardiogram: A non - invasive test that takes a picture of the heart with sound waves to check for any structural abnormalities.
5. Pulmonary function testing: Involves breathing into a mouthpiece connected to an instrument that measures the amount of air breathed over a period of time to assess lung function.
6. Chest X - ray: Can provide a basic view of the chest structure.
7. CT - scan: Gives a more detailed view of the chest and is used to calculate the Haller index.
8. 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 3 Hospitals for Pectus Excavatum Correction in New York City

NewYork - Presbyterian Queens

Thoracic Surgery Program

NewYork - Presbyterian Queens has an outstanding 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. Their thoracic surgeons, in collaboration with Weill Cornell Medicine, provide the latest in surgical techniques and comprehensive care for patients with diseases of the lung, trachea, esophagus, chest wall, and mediastinum.

Treatment for Pectus Excavatum

They offer the minimally invasive Nuss procedure for pectus excavatum. The procedure is performed using video - assisted thoracoscopic surgery (VATS). During the Nuss procedure, 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. The majority of patients at NewYork - Presbyterian Queens are able to have their pectus excavatum 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. This 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.

Multidisciplinary Team

The hospital has a multidisciplinary team of 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. This team collaborates to deliver seamless, high - quality care to patients before, during, and after their hospital stay.

Columbia University's Surgical Lung & Chest Care Program

Reputation and Expertise

As part of Columbia University Irving Medical Center and New York - Presbyterian, this program prides itself on being consistently named one of New York’s top hospitals and one of the top ten medical centers in the nation. It extends its top - ranked care to its offices in New Jersey as well. The program's surgeons are leaders in the field. They have developed the largest lung transplant program in the north Atlantic, established a special program addressing lung disease in women, and created the world’s only comprehensive center for diaphragm disorders.

Pectus Excavatum Treatment

For pectus excavatum, they offer both the minimally invasive Nuss procedure and the modified Ravitch repair. The Nuss procedure here follows the standard technique of creating small incisions and using a specially shaped bar to correct the sunken chest. The modified Ravitch repair is 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 current bars can remain permanently in place, avoiding the need for a second operation.

Patient - Centered Care

The program focuses on putting people first. The medical team not only treats conditions but also treats patients with respect and clear communication. They are committed to individual respect and ensuring that patients are fully informed about their treatment options.

NYU Langone Health

Expert Doctors

NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for patients with pectus excavatum. The doctors at NYU Langone have in - depth knowledge and experience in diagnosing and treating this condition.

Comprehensive Approach

They take a comprehensive approach to pectus excavatum treatment. This includes a detailed pre - operative evaluation to understand the patient's specific condition and needs. They may use various diagnostic tools such as the ones mentioned earlier to accurately assess the severity of the pectus excavatum. During the treatment, they offer a range of surgical options depending on the patient's age, the severity of the condition, and other individual factors. Whether it is the minimally invasive Nuss procedure or a more traditional open surgery in some cases, the doctors at NYU Langone choose the most appropriate treatment for each patient. After the surgery, they provide close follow - up care to ensure proper healing and monitor the patient's recovery. They also offer support and guidance to help patients return to their normal activities as smoothly as possible.

Benefits of Minimally Invasive Surgery for Pectus Excavatum

Most of the top hospitals in New York City offer minimally invasive surgery for pectus excavatum, such as the Nuss procedure. The benefits of minimally invasive surgery are numerous:

1. Less pain: Since the incisions are small, there is less trauma to the surrounding tissues, resulting in less postoperative pain.
2. Shorter hospital stay: Patients can usually leave the hospital within a few days after minimally invasive surgery compared to a longer stay with open surgery.
3. Faster recovery: With less pain and tissue damage, patients can return to their normal activities, such as school or work, more quickly.
4. Better cosmetic results: The small incisions lead to less scarring, which is often a concern for patients, especially children and teenagers.

Considerations When Choosing a Hospital for Pectus Excavatum Correction

When deciding on a hospital for pectus excavatum correction, the following factors should be considered:

1. Expertise of the medical team: Look for hospitals with experienced surgeons who specialize in pectus excavatum correction. Check their credentials, the number of procedures they have performed, and their success rates.
2. Treatment options: A good hospital should offer a variety of treatment options, including both minimally invasive and traditional surgical procedures, to suit the individual needs of patients.
3. Multidisciplinary approach: A hospital with a multidisciplinary team of doctors, nurses, and other healthcare professionals can provide comprehensive care before, during, and after surgery.
4. Patient reviews and testimonials: Reading about the experiences of other patients can give you an idea of the quality of care and the patient - centered approach of the hospital.
5. Location and convenience: Consider the location of the hospital and how easy it is for you to travel there for appointments, surgery, and follow - up care.

Conclusion

Pectus excavatum is a condition that can have a significant impact on a person's health and well - being. However, with the advanced treatment options available at top hospitals in New York City, patients have a good chance of successful correction. NewYork - Presbyterian Queens, Columbia University's Surgical Lung & Chest Care Program, and NYU Langone Health are three hospitals that stand out for their expertise in pectus excavatum correction. These hospitals offer state - of - the - art surgical techniques, a multidisciplinary approach to care, and a commitment to patient - centered treatment. If you or someone you know is considering pectus excavatum correction, we encourage you to do further research, schedule consultations with the hospitals mentioned in this article, and make an informed decision based on your specific needs. Share this article with others who may benefit from this information and explore more about pectus excavatum treatment and related topics on medical websites and platforms.