Pectus Excavatum Surgery Abroad

Nuss Procedure Package Cost: 3,400 -15,000 US Dollars
For an accurate estimate, we require an x-ray of the chest {front & side view} & medical history/condition information

India [Reputed & JCI-Accredited Hospitals]
Mexico [World-Class Hospitals]
Thailand [World-Class Hospitals]

Pectus excavatum is the most common form of congenital chest wall deformity. It is sometimes also referred to as ‘funnel chest’. Pectus excavatum is the abnormal growth found in the costal cartilages between the sternum (breastbone) and ribs. In such an abnormal growth in the cartilages, the sternum appears sunken or, on in some cases, rotates to one side or the other.

The overall incidence of pectus excavatum is reported to be 1 in 1000. As of now, the exact cause of pectus excavatum is unclear. Definitive research says that 46 percent of patients have a family history of pectus excavatum. Pectus excavatum tends to affect males more often than females. This has led many experts and surgeons to believe that some genetic factors are involved with pectus excavatum, including male gender.

Pectus excavatum causes numerous problems; moderate to severe PE can result in major complications. In moderate and severe pectus excavatum, the patient’s heart compresses and displaces into the left chest. This limits the amount of blood, the heart is capable of pumping per beat. This may become evident when the patient is working out and his heart has to beat faster to compensate for this compression.

In moderate to very severe defects, the heart displaces to the sternum’s left or the midline. This causes a murmur, which is actually due to the pressure on the system causing rough flow instead of a smooth flow.

In human anatomy, one of the main functions of the rib cage is to act as a shield for the lungs and heart. In pectus excavatum, the rib cage is shaped differently. The heart and lungs are still protected by the ribs but the concave shape of the rib cage may cause these vital organs to be compressed. This restriction may prevent normal contractions leading to cardiac limitations.

In addition, the defect tends to restrict the amount of air entering the lungs. This, again, becomes evident during physical activity, when the patient feels that he cannot keep up with his peers. Other problems include psychosocial and emotional disturbances of having a chest deformity.

Some of the pectus excavatum symptoms are:

• Chest pain: research has suggested that almost two thirds of surgical patients with pectus excavatum have a history of chest pain
• Shortness of breath during exercise: patients experience a shortness of breath or have lack of stamina when they are exercising.
• Psychosocial effects: patients with pectus excavatum are conscious and insecure about the deformity in their chest wall.

Diagnosis for Pectus Excavatum

Before surgical treatment is decided, a pectus deformity is diagnosed. Doctors observe the patient having a chest deformity or having difficulty in breathing. The next step is an x-ray or CT scan or even MRI scan, to better understand the pectus deformity’s scope and structure.

Then the patient’s Haller index is measured. The Haller is calculated by obtaining the measurement of inside left to inside right of the ribcage and dividing that by the distance from the sternum to the spine. A normal chest has an index of 2.5 and a Haller Index greater than 3.25 is generally considered severe.

Non-Surgical Treatments for Sunken Chest

Pectus excavatum is damaging only in the severest of the cases. For most cases, doctors don’t advice surgery and ask the patient to consider non-surgical treatments. Since attitude often plays a significant role in adjusting to a pectus deformity and patient’s well-being, many patients go for psychological counseling. Depending on the severity of the condition, counseling therapies help the child develop coping strategies.

Physiotherapies, such as exercises and improvement of posture, sometimes provide benefit in terms of appearance, and lung and heart performance. Body-developing exercises can worsen appearance because of larger pectoral muscles that amplify the chest deformity.

But certain aerobic exercises have proved beneficial for patients suffering from pectus excavatum. In addition, any patient who tends to slouch or has rounded shoulders stands to gain from certain techniques.

Surgery Treatment for Pectus Excavatum

Doctors usually recommend surgery only after the patient has reached mid-teens, this is due to the fact that, in several past instances, younger patients had their chest buckle-in again after the surgery. Although improvement in cosmetic appearance is a bonus benefit, the surgeries are carried out mainly for physiologic reasons, not for cosmetic.

Surgical procedures include:

The Nuss Procedure is a less invasive procedure, developed in the 1980s, to correct the more common excavatum in younger patients (age 5-15). Nuss surgery involves, the making of small incisions to insert one or more metal rods behind the sternum. The bars force the sternum into its proper position. These bars are then left in place for about two years before they’re removed. Doctors do not recommend this procedure for older patients whose bones are thicker and more brittle, or for patients with carinatum.

Ravitch Procedure. In this, the sternum is detached from the ribs and turned around to lie flat. It is then reconnected and reinforced with metal struts or rods to hold its proper position during recovery. Ravitch is a major invasive procedure, which creates a significant scar and calls for painkillers.

The patient is made to exercise causing shortness of breath and forcing the lungs to expand to their actual capacity. Only non-contact activities are prescribed for 4 months, while the bones are healing. Following this, a second surgery is programmed to remove the metal rods. The procedure is the most common and highly successful one, but is complex and the recovery can be slow.

A newer, invasive reconstructive procedure is the Leonard Procedure. In the Leonard procedure, the cartilage is removed from the lower ribs and the sternum undergoes modifying. Then chest cavity is rebuilt and reshaped using wires to reconnect and support the bones. The wires are fixed to an external plastic “Jewitt” brace, which is worn for six weeks as a traction device.

A fourth type of surgical procedure is Silicone Implants, that can provide some amount of cosmetic improvement for patients, especially in the case of older patients, with minor to moderate cases of excavatum.

Pectus Carinatum V/s Pectus Excavatum

Pectus carinatum, or protrusion of the breast, also called pigeon breast, is a completely different malformation. Pectus carinatum (PC, or “pigeon chest”) in which the sternum is raised and so the chest pushed out. It is a complete reverse condition of pectus excavatum.

Another significant difference is, in pectus carinatum the heart is in its normal position and murmurs are very rare, whereas, in pectus excavatum the heart is displaced to the left of the sternum or the midline which may cause a murmur.

The surgeries are also different, given the formation of the conditions. The surgical correction for pectus carinatum involves bilaterally removing the cartilages that are affected and the excess cartilage over the sternum. A reverse wedge is carried out on the sternum. This is followed by a bracing that is in a compression system rather than outward rigging as required by pectus excavatum.

Low Cost Nuss Procedure Surgery in India

For some patients suffering from pectus excavatum, in U.S. and U.K., the surgery bills can run into anywhere between $75,000 and $150,000. In such cases, patients can opt to go in for sunken chest repair surgery, in countries like India.

Your medical treatment and surgery can be easily handled in India, as the quality of healthcare available in India is simply one of the best in the world. The surgeons are USA/UK trained and the hospital facilities and equipments are 5-star.

The cost for Nuss procedure surgery in India comes at a fraction of the costs, charged in U.S. and U.K. Medical Tourism Corporation’s network of hospitals can provide you pectus excavatum repair surgery from 3,400 -15,000 US dollars.

This package includes hospital stay, laboratory tests, anesthesia, operation theater fees, doctors fees, ride to and from the hospital, ride to and from recovery center, and medicines.

Medical Tourism Corporation facilitates affordable pectus excavatum surgery abroad in India. Fill out the free estimate request form for a free quote and more information.