Children with moderate to severe defects often report exercise intolerance manifested by shortness of breath and chest pain on exertion. The displacement and compression of the heart and lungs may explain these symptoms. In the past, a variety of radical procedures were advocated. However, a new technique for correction of pectus excavatum has been developed and refined by Dr Donald Nuss, a pediatric surgeon at Children s Hospital of the King s Daughters in Norfolk, Virginia. The Nuss Procedure allows complete repair of the pectus excavatum deformity without the need for an anterior skin incision, rib resections, or fracture of the sternum.
Blood loss is minimal and recovery time short.
After a complete health history, thorough physical examination, and measurements, children whose condition is considered severe enough to warrant surgery undergo a chest CT scan. The CT scan helps confirm that a child fulfills established criteria for surgery since not every child requires surgical correction. Focused cardiology and pulmonary consultations are obtained for unique signs and symptoms. Under general anesthesia, two small lateral incisions are made on each side of the chest for insertion of a curved metal bar beneath the sternum. A tiny video camera is inserted into the chest to monitor proper bar placement.