Introduction
Pectus excavatum is a relatively common congenital chest wall deformity that can have a significant impact on a patient's physical and psychological well - being. In New York City, several hospitals stand out for their excellence in treating this condition through surgical interventions. This article will delve into the top three hospitals for pectus excavatum surgery in New York City, providing in - depth information about their services, expertise, and patient outcomes.
Understanding Pectus Excavatum
Pectus excavatum is a malformation of the chest wall in which several ribs and the sternum (breastbone) grow abnormally, resulting in a caved - in or sunken appearance. It is more common in males than in females, and approximately 40% of people with pectus excavatum have one or more family members with the defect (Columbia Surgery).
The condition may be present at birth or develop during puberty. Severe cases can affect lung capacity, causing fatigue, shortness of breath, chest pain, and a fast heartbeat. In some cases, it may also cause a heart murmur due to the proximity of the sternum and the pulmonary artery. Pectus excavatum can also have negative psychosocial effects on children and teenagers, who may feel self - conscious about their appearance and avoid activities that expose the chest.
Diagnosis of Pectus Excavatum
Multiple tools are used to diagnose pectus excavatum and gauge its extent. These include:
- Visual examination of the chest: A doctor can often detect the sunken appearance of the chest wall through a simple visual inspection.
- Auscultation: Analysis of the 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 to check for any abnormalities.
- Echocardiogram: A non - invasive test that uses sound waves to create a picture of the heart, helping to assess the heart's structure and function.
- Pulmonary function testing: Involves breathing into a mouthpiece connected to an instrument that measures the amount of air breathed over a period of time, providing information about lung capacity and function.
- Chest X - ray: Can give a general view of the chest and help identify any obvious skeletal abnormalities.
- CT - scan: Provides detailed cross - sectional images of the chest, which are useful for measuring the extent of the pectus excavatum and planning surgical intervention.
- Haller index: 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).
Surgical Treatment of Pectus Excavatum
The ideal age for surgical treatment of pectus excavatum is between 12 and 18 years when the chest's cartilage and bones are still malleable. The goal of surgery is to improve breathing, posture, and cardiac function, as well as to give the chest a normal appearance. The two main surgical procedures for pectus excavatum are the Nuss procedure and the modified Ravitch repair.
Nuss Procedure
The minimally invasive Nuss procedure is performed under general anesthesia. Using video - assisted thoracoscopic surgery (VATS), the surgeon creates a horizontal passage underneath the sternum through two small incisions in the side of the chest. A convex bar, known as the Lorenz pectus bar, which is specially shaped to fit the individual's anatomy, is 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. The bar is removed as an outpatient procedure.
Modified Ravitch Repair
This procedure is also performed under general anesthesia. It involves making a horizontal incision and 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. Unlike in the past, the current bars can remain permanently in place, eliminating the need for a second operation to remove the supports.
Top Three Hospitals for Pectus Excavatum Surgery in New York City
Columbia University's Surgical Lung & Chest Care Program
Columbia University's surgical lung and chest care program, as part of Columbia University Irving Medical Center and New York - Presbyterian, is a leading institution for pectus excavatum surgery in New York City.
Expertise and Experience
The program has a team of highly experienced thoracic surgeons who are leaders in the field. They have extensive experience in performing both the Nuss procedure and the modified Ravitch repair for pectus excavatum. For example, Dr. Lyall A. Gorenstein, a thoracic surgeon affiliated with New York - Presbyterian/Columbia University Irving Medical Center, specializes in minimally invasive thoracic surgery, including the treatment of pectus excavatum. He graduated from Canada in 1983 and has completed his training at multiple prestigious institutions, and is board - certified in surgery and thoracic surgery (Castle Connolly).
Patient - Centered Care
The program is committed to patient - centered care. The team not only treats the medical condition but also focuses on the individual patient. They communicate clearly with patients and their families, explaining the surgical procedures, risks, and expected outcomes. They are dedicated to providing personalized care plans based on each patient's unique needs and circumstances. For instance, they take into account the patient's age, the severity of the pectus excavatum, and any associated medical conditions when planning the treatment.
Research and Innovation
Columbia University is at the forefront of research in thoracic surgery. The surgical team is involved in ongoing research to improve the surgical techniques and outcomes for pectus excavatum. They are constantly exploring new ways to minimize the invasiveness of the procedures, reduce complications, and enhance the long - term results for patients. This commitment to research ensures that patients receive the most up - to - date and effective treatments available.
NewYork - Presbyterian Queens
NewYork - Presbyterian Queens is another outstanding hospital for pectus excavatum surgery in the city.
Minimally Invasive Surgical Expertise
The hospital has one of the most sophisticated minimally invasive thoracic surgery programs in the world. Their thoracic surgeons are trained in the latest cutting - edge techniques, including robotic and video - assisted thoracic surgery. For pectus excavatum, they offer the minimally invasive Nuss procedure, which results in less blood loss, less postoperative pain, shorter hospital stays, and a quicker recovery and return to normal activities compared to traditional open surgery. This is especially beneficial for patients, as it allows for a faster return to their daily lives and reduces the overall impact of the surgery on their well - being.
Multidisciplinary Team Approach
The hospital takes a multidisciplinary approach to patient care. A 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 collaborate to provide seamless, high - quality care to patients before, during, and after their hospital stay. This comprehensive approach ensures that all aspects of the patient's care are addressed, from the initial diagnosis to the long - term follow - up.
Outstanding Patient Outcomes
NewYork - Presbyterian Queens 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. This high - quality rating reflects the hospital's commitment to excellence in surgical care and suggests that patients undergoing pectus excavatum surgery can expect positive outcomes. The hospital's focus on using the latest techniques and providing personalized care contributes to the high success rate of the surgeries and the satisfaction of the patients.
NYU Langone Health
NYU Langone Health is well - known for its comprehensive approach to treating pectus excavatum.
Comprehensive Care Services
NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for patients with pectus excavatum. They offer a full range of services, including pre - operative evaluation, surgical treatment, and post - operative follow - up. The pre - operative evaluation involves a detailed assessment of the patient's condition, including physical examinations, imaging studies, and pulmonary and cardiac function tests. This helps the doctors to accurately determine the best treatment plan for each patient.
Experienced Medical Staff
The hospital has a team of experienced medical professionals who are experts in the field of thoracic surgery. These doctors have years of experience in performing pectus excavatum surgeries and are well - versed in the latest surgical techniques. They continuously update their knowledge and skills through ongoing education and training, ensuring that they can provide the best possible care for their patients.
Patient Education and Support
NYU Langone Health places a strong emphasis on patient education and support. They provide patients and their families with detailed information about pectus excavatum, the surgical procedures, and the recovery process. This helps to alleviate any concerns or fears that patients may have and enables them to make informed decisions about their treatment. The hospital also offers support services during the recovery period, such as physical therapy and counseling, to help patients fully recover and regain their quality of life.
Comparing the Top Three Hospitals
| Hospital | Expertise and Experience | Patient - Centered Care | Research and Innovation | Minimally Invasive Options | Multidisciplinary Approach |
|---|---|---|---|---|---|
| Columbia University's Surgical Lung & Chest Care Program | Highly experienced thoracic surgeons, including Dr. Lyall A. Gorenstein | Personalized care plans, clear communication with patients and families | Ongoing research to improve surgical techniques | Offer both Nuss and modified Ravitch procedures | Collaboration among different medical specialties |
| NewYork - Presbyterian Queens | Surgeons trained in the latest minimally invasive techniques | Multidisciplinary team ensures comprehensive care at all stages | May incorporate new techniques through access to latest research | Advanced minimally invasive thoracic surgery program, especially Nuss procedure | Multidisciplinary team including various medical professionals |
| NYU Langone Health | Experienced medical staff in thoracic surgery | Full range of services from pre - op to post - op, patient education | Continuous training of staff to stay updated | Offer advanced surgical options | Comprehensive care with different specialists involved |
Factors to Consider When Choosing a Hospital for Pectus Excavatum Surgery
Surgeon's Experience
The experience of the surgeon performing the pectus excavatum surgery is crucial. Look for surgeons who have performed a large number of these surgeries and have a proven track record of successful outcomes. Surgeons with more experience are more likely to handle any complications that may arise during the surgery and are better able to achieve the desired results.
Hospital's Reputation
Consider the hospital's overall reputation in the field of thoracic surgery. Hospitals with high - quality ratings, such as those recognized by national or international medical organizations, are more likely to provide excellent care. A good reputation also indicates that the hospital has a history of successful surgeries and satisfied patients.
Available Treatment Options
Ensure that the hospital offers a variety of treatment options for pectus excavatum, including both minimally invasive and traditional surgical procedures. The availability of different options allows the medical team to choose the most appropriate treatment based on the patient's specific condition, age, and overall health.
Multidisciplinary Care
Hospitals that take a multidisciplinary approach to patient care are often better equipped to handle all aspects of pectus excavatum treatment. A team of specialists, including thoracic surgeons, pulmonologists, cardiologists, and physical therapists, can work together to provide comprehensive care and support for the patient before, during, and after surgery.
Patient Reviews and Testimonials
Reading patient reviews and testimonials can provide valuable insights into the hospital's quality of care, patient experience, and the overall satisfaction of previous patients. Look for reviews that specifically mention pectus excavatum surgery to get a better understanding of what to expect.
Conclusion
In New York City, Columbia University's Surgical Lung & Chest Care Program, NewYork - Presbyterian Queens, and NYU Langone Health are the top three hospitals for pectus excavatum surgery. Each hospital has its own strengths, whether it's the expertise of the surgical team, the focus on minimally invasive techniques, or the commitment to patient - centered care. When choosing a hospital for pectus excavatum surgery, patients and their families should carefully consider the factors mentioned above to make an informed decision.
If you or someone you know is suffering from pectus excavatum, don't hesitate to reach out to these top - rated hospitals. Contact the hospital directly to schedule a consultation and take the first step towards a better quality of life. Share this article with others who may be interested in learning more about pectus excavatum surgery in New York City.
