Pectus excavatum is a congenital chest wall deformity that causes several ribs and the sternum (breast bone) to grow abnormally. The condition may also be referred to as sunken or funnel chest because of the caved-in shape the condition produces. Pectus excavatum is usually present at birth but may become more prominent during adolescent growth spurts. In some cases, the condition causes nothing more than a sunken chest, which ma cause some self-esteem issues, but is not cause for medical concern. In severe cases, however, the sunken breast bone may interfere with heart and lung function. In these severe cases, medical intervention is required to live a normal, healthy life.

Your pediatrician will generally be able to diagnose the condition shortly after birth and will monitor it for health effects throughout the child’s life. If the depression causes concern in infancy, they may recommend intervention early, while the bones and body structure are still developing.

Symptoms that may indicate the need to intervene include:

  • A decrease in physical activity tolerance
  • Racing heart or heart palpitations
  • Frequent respiratory infections
  • Chronic fatigue
  • Heart murmur
  • Chest pain
  • Wheezing or coughing, worsening with exertion

Pectus Excavatum Correction

Treatment of pectus excavatum will depend on the severity of the case and how much it is impacting heart and lung function. For mild cases, physical therapy may be used to help improve posture and muscle tone in an effort to maximize chest expansion. For moderate to severe cases, there are surgical procedures that may be performed to help correct the condition.

One route is a minimally invasive procedure that uses small incisions on both sides of the chest. A long, narrow tool is used to thread a curved metal bar underneath the breastbone. In some cases, multiple bars may be used, depending on the severity of the case and the length of the breastbone. The bars are typically left in place for two to three years and then removed when the desired repair is achieved. You can think of these small bars as an internal bone brace.

Another option, which is used for more severe cases or in cases where deformed cartilage attaching the ribs to the breastbone prevents bracing, is an open chest surgery. In this invasive procedure, an incision is made in the center of the chest so that the sternum can be visualized. The breastbone is removed, along with any excess cartilage, and then fixed back into a more normal position using surgical hardware that will stay in place for six to 12 months while the bone joints heal. 

Pectus excavatum correction surgeries have proven to be successful at improving the look and function of the chest. Surgical intervention may be delayed until about the time of adolescent growth spurts for the best outcomes. However, your family, your pediatrician, and your pediatric surgical team will discuss your child’s individual case and the best course of treatment.

How Alaska Pediatric Surgery Can Help

At Alaska Pediatric Surgery, our surgical team has been correcting pectus excavatum in Alaska’s children for decades. We have had very successful outcomes and most patients are happy with how their chest appears after surgical intervention. If your child has been diagnosed with pectus excavatum, contact Alaska Pediatric Surgery to schedule your evaluation today.

Information Sheet
Kids Health