What is Pectus Excavatum?
The below explanation of Pectus Excavatum is how the author would explain the condition in her own words. If you would like a more technical, medical explanation, visit www.emedicine.com/PED/topic2558.htm or ask your doctor. This explanation is meant to explain the condition in a simple way, not to influence your treatment.
Pectus Excavatum is a malformation of the chest wall– primarily affecting the sternum and the ribs. At birth, one often notices a slight dip in the center of the baby’s chest. As the child gets older the condition often worsens, but in varying degrees. Doctors examine a CT scan or an X-ray to determine how severe the condition is. Typically, doctors take a measurement of the width of the chest cavity divided by the measurement from the sternum to the spine (a depth measurement where the chest is sunken in). Basically, the chest width divided by the depth. These measurements cannot be taken on the outside of the person– thus, the need for the tests. My internal chest width was about 25cm and I only had 5 cm between her sternum and spine. By dividing these two numbers a Haller index is obtained. My Haller Index was a 5.1. It is typically understood that a Haller Index greater than 3.25 indicates a possible need for surgery. Surgery is ideally performed on children ages 9 – 11 years of age because the chest wall of children is more pliable. But surgery can be performed on some adults as well. I had just turned 26 years old when
I had the procedure. I do not know if anyone does surgery on patients who are older than 30 years of age. Patients and their parents have a choice between the Ravitch Procedure and the Nuss Procedure. Some doctors only perform one surgery or the other. The Nuss Procedure is less invasive. Surgeons make two incisions on either side of the chest under the arms. A metal bar is inserted under the chest wall and is used to push the sternum out. The bar is secured and left in for 2-3 years. When removed, the chest wall should remain in the desired position.
Although Pectus Excavatum can be fixed for cosmetic reasons, actions are usually taken because the Pectus Excavatum is causing cardio and/or respiratory problems. If the Haller Index is large enough, surgery may be recommended even if cardio or respiratory problems are not found. In my case, I did not have major cardio or respiratory problems, but my heart was being compressed in such a way doctor’s recommended surgery to avoid future complications.