1. A New Perspective on Correction
Pectus Excavatum
A New Perspective on Correction

2. What is Pectus Chest wall abnormality1
Sternum and ribs depressed inwards
Number one birth defect in males2
1 of 8
92% of patients unaware it could be affecting their health2
Fronkalsrud, EW M.D.
Nuss D, Kelly M.D.

3. Symptoms Physical Psychological
Chest pain, cardiac/respiratory complications, lack of stamina3
Psychological
Self conscious behavior, loss of motivation, anxiety1
Often misdiagnosed by the doctor or ignored by the patient2
Three procedures
Nuss
Ravitch
Silicone implants
Shamberger, RC M.D.
Nuss D, Kelly M.D.

4. Claim
Nuss procedure is a more successful procedure for surgical correction of pectus excavatum than the Ravitch procedure.

5. Warrants Minimally invasive surgery
Faster recovery than invasive surgery1
What is a successful pectus surgery?
Dr. Cohn: leading pectus excavatum surgeon2
Six Criteria:
Relief of cardiac/pulmonary compressions
Adequate pain management
Length of hospital stay
Time to return to normal activity
Duration of daily medication
Physical appearance
Operating time you want as short as possible1
Less blood loss
68% something unexpected happens under anesthesia
Fonkalsrud, EW M.D.
Nuss, D Kelly M.D.

6. Procedure
Ravitch Procedure
Nuss Procedure
Nuss Procedure

7. Evidence Study on 8 patients4 Data Collected
Minimally invasive Nuss 4 patients
Ravitch 4 patients
Five Men & Three Women
Data Collected
Operating time, duration of epidural, pain scores, hospital stay, alleviation of symptoms, time to return to normal activity, complications, duration of post-hospitalization pain medication, and physical appearance.
Cohn, Dale M.D.

8. Evidence Ravitch Complications 2 suffered from cardiac compressions
1 collapsed lung – admitted to ICU
3 inhibited chest wall growth
2 urinary retention
4 dissatisfied with scar

9. Before & After
Ravitch Procedure
Nuss Procedure

10. Conclusion Nuss procedure offers many benefits
Reduced operating time, effectively stabilizes chest, vastly reduces scaring, maintains chest elasticity, does not inhibit chest growth, drastically reduces blood loss, creates more space for vital organs

11. References
Fonkalsrud, EW M.D. Repair of pectus excavatum and caratum in adults. American Journal of Surgery ; 101:
Nuss, D Kelly M.D. A 10 year review of a minimally invasive technique to the correction of pectus excavatum. Journal of Pediatric Surgery ; 33:
Shamberger, RC M.D. Cardiopulmonary function is pectus excavatum. Surgery 1988; 166:
Cohn, Dale M.D. What is new in pectus excavatum surgery. Journal of Surgery ; 38: