Symptoms of pectus excavatum
Symptoms often include:
- Shortness of breath
- Chest pain
- Exercise intolerance
- Body image issues
Stay active while living with pectus excavatum
Encourage your child to live an active lifestyle without any restrictions, unless your care team recommends otherwise. People who have pectus excavatum can continue to participate in all activities they find enjoyable.
Some symptoms may get worse with physical activity but the activity itself does not pose a health risk. Pay attention to activities that seem to cause problems and ask your child's pectus team if there is any relation.
Treatment options for pectus excavatum
Pectus excavatum typically becomes more noticeable during puberty when your child begins to grow rapidly.
Adolescents with a severe case of pectus excavatum and associated symptoms may be a candidate for surgical repair during the teenage years with the minimally invasive repair of pectus excavatum (MIRPE).
Vacuum Bell Therapy (VBT) offers a nonsurgical treatment option for pectus excavatum. VBT uses a suction device to gradually lift the sternum/chest wall. Correction using VBT typically does not improve the appearance of the chest as much as surgical correction. However, for some children, VBT represents a potential alternative to surgery.
Testing for pectus excavatum
Your pectus care team may recommend a chest CT (CAT scan) of your child's chest to determine how severe their condition is. The CT scan can measure the indented chest depression and help your care team to determine the best treatment option for your child. The CT scan is not painful and simply requires your child to lie still for about 5-10 minutes while a series of pictures are taken.
Additional testing (such as an exercise stress test, pulmonary function tests or an echocardiogram) may be required by your insurance company if you are considering surgery. Sometimes, surgery is not covered by insurance. We recommend checking with your insurance company for specifics.
Pectus excavatum surgery: Nuss procedure and MIRPE
Minimally invasive repair of pectus excavatum (MIRPE)
Doctors began using open surgery to correct pectus excavatum in the early 1900s. Eighty years later, Donald Nuss, MD, a Norfolk, Va. doctor, came up with an approach that was less invasive. Since then, the surgeons at Children’s Mercy have modified the Nuss procedure to include a central incision that allows safe passage of the bar across the chest.
During the MIRPE procedure, the surgeon inserts a steel bar that has been bent to fit under the sunken sternum and around the front of the chest. The bar helps reshape the chest as the child grows.
After about three years, the bar is removed in a same-day procedure. This pectus excavatum repair is highly effective. Less than 1 percent of children will develop the condition again.