21. CHKD: About Us: Services And Programs - Surgical Services - Nuss Procedure Site Search. Find A Doctor. The Nuss Procedure for pectus excavatum.Children's Hospital of The King's Daughters has put together a http://www.chkd.org/about_us/nuss_procedure.asp

More Health Information Adolescent Medicine Allergy/Immunology Anesthesiology Arthritis Burns Cardiology Craniofacial Dental Medicine Dermatology Developmental Peds Diabetes Digestive Ear, Nose, Throat Genetics Gastroenterology Growth Hematology High Risk Newborn High Risk Pregnancy Infectious Disease Mental Health Neonatology Nephrology Neurology Normal Newborn Normal Pregnancy Oncology Ophthalmalogy Orthopaedics Otolaryngology Pediatric Intensive Care Pediatric Surgery Pediatrics Physical Medicine Plastic Surgery Respiratory/Pulmonology Rheumatology Safety Surgery Terminal Transplant Urology Site Search The Nuss Procedure for Pectus Excavatum Children's Hospital of The King's Daughters has put together a collection of resources that explains the new Nuss Procedure to correct pectus excavatum, also known as sunken or funnel chest. Please examine the contents below and contact us at (757) 668-8798 (Voice mail box only) with any questions you may have. Contents The Nuss Procedure and Pectus Excavatum: an overview Smooth Surfing Ahead! Tye's Story. Sunken chest, raised hopes: New surgery fixes deformity with less trauma than ever Abstract of a paper presented at the May 1997 meeting of the American Pediatric Surgery Association ... Terms and Conditions

22. My Pectus Excavatum Experience - Home Page Pectus Excatavum website, including personal experience with the nuss procedure, surgery information, medical tests, photos, pictures, and more. http://sunfrogservices.com/pectus/

23. Welcome To My Pectus Excavatum Experience Welcome to my pectus excavatum experience. This site was last updated 03 Aug 2002.BEFORE the Surgery. nuss procedure pectus excavatum. AFTER the Surgery. http://sunfrogservices.com/pectus/frame_body.html

Welcome to my Pectus Excavatum experience. The reason I made this site is to share my experience as an adult who had his Pectus Excavatum corrected. My Pectus Excavatum was repaired using a Modified Nuss Bar Procedure. I will continue to provide monthly updates on my post operation recovery. This site was last updated 03 Aug 2002. BEFORE the Surgery AFTER the Surgery You are visitor number: If you have any questions send an email to mdiehlusa@yahoo.com Website Design, Web Hosting: http://www.sunfrogservices.com

24. My Pectus Excavatum Experience - Home Page Includes personal experience with the nuss procedure, surgery information, medical tests, and photos. http://www.sunfrogservices.com/pectus

25. Pectus Excavatum, Cincinnati Childrens Hospital Medical Center Information about pectus excavatum, provided by the division of Pediatric Surgeryat Cincinnati Children's Hospital Medical Center. What is pectus excavatum? http://www.cincinnatichildrens.org/Health_Topics/Your_Childs_Health/chest_and_lu

Your Child's Health Chest and Lungs Conditions and Diagnoses Overview ... Pectus Carinatum Pectus Excavatum Pneumonia, Community Acquired Respiratory Syncytial Virus (RSV) Signs of Respiratory Distress Tracheoesophageal Fistula and Esophageal Atresia ... Tests and Procedures Conditions and Diagnoses Pectus Excavatum (A chest wall deformity) What is pectus excavatum? Commonly called "funnel chest," pectus excavatum is a depression or hollow caused when the sternum (breastbone) is abnormally pushed inward. The depression in the chest is due to abnormal growth of the cartilage that attaches the sternum to the ribs. Because of the deep depression, the abdomen often protrudes and gives the appearance of a potbelly in younger children. If both sides of the breastbone are depressed in an equal fashion, the defect will appear symmetrical. However, in many cases, the chest wall appears asymmetric, with the left side of the chest being wider than the right side. In such cases, the sternum is abnormally rotated. Pectus excavatum occurs in 1 in 500 to 1,000 children. It may be minimal, with only slight depression of the chest or it may be quite severe, causing compression of the heart and lungs and altering their functioning. The abnormality increases with age and often worsens during the growth spurts that occur during late childhood and adolescence. It stabilizes after skeletal growth is complete. What causes pectus excavatum?

26. Pectus Excavatum pectus excavatum Repair. pectus excavatum surgically corrected. Boys are threetimes more likely to have pectus excavatum than girls. Why surgery? http://www.childrensurgery.com/pectus-excavatum.html

Aloha Picture of Paradise About the Doctor About the Hospital ... Hirschsprung's Disease: Dr. to Dr. Pectus Excavatum Repair Pectus Excavatum (pek’tus excava’tum) “hollowed breast” or “funnel chest” is a common chest deformity that can be surgically corrected. Boys are three times more likely to have pectus excavatum than girls. Why surgery? To relieve structural compression of the chest and allow normal growth of the thorax To prevent pulmonary and cardiac dysfunctions To improve a child’s self image especially in sports where the chest is exposed Who is the surgeon? Dr. Shim is a Pediatric Surgeon who is board certified in Pediatric Surgery and operates upon children from premature infants to adolescents and whose problems range from skin lesions to complex congenital defects. Pectus excavatum is one of the moderately complex surgeries of childhood in which Dr. Shim specializes. Where will the surgery be performed?

27. Pectus Excavatum Dr. To Dr. pectus excavatum. Dr. to Dr. Pectus pectus excavatum is associatedwith scoliosis in the same patient and in family members. Marfan http://www.childrensurgery.com/Pectus-Excavatum-DrtoDr.html

Aloha Picture of Paradise About the Doctor About the Hospital ... Hirschsprung's Disease: Dr. to Dr. Pectus Excavatum Dr. to Dr. Pectus Excavatum or “sunken chest” and its less common counterpart Pectus Carinatum or “pigeon breast” are not uncommon deformities of the anterior chest whose etiology is poorly understood. The deformity occurs in a male-to-female ratio of 3:1. The most understandable explanation is that uncontrolled overgrowth in rib length causes buckling forcing the sternum posteriorly or anteriorly. This displacement is usually symmetric but may be asymmetric, causing a rotation of the sternum. It is usually accompanied by a protrusion of the lower costal margin thus tending to deepen the excavatum defect, which may range from mild to severe. A genetic cause is suggested by the association of family members with chest wall deformities. Pectus Excavatum is associated with scoliosis in the same patient and in family members. Marfan’s syndrome should be considered in patients with a severe pectus deformity, and congenital heart disease is an occasional comorbidity.

28. Jacobs - Pectus Excavatum Minimally Invasive Endoscopic Repair of pectus excavatum. Patient Selection.Figure 1. The typical appearance of a pectus excavatum deformity. http://www.ctsnet.org/doc/6705

CTSNET Experts' Techniques, General Thoracic Experts' Techniques Section Editor: Mark K. Ferguson, M.D. Navigation Menu Patient Selection Operative Steps Preference Card Tips and Pitfalls ... References Minimally Invasive Endoscopic Repair of Pectus Excavatum Jeffrey P. Jacobs, M.D. www.heartsurgery-csa.com Cardiac Surgical Associates Division of Thoracic and Cardiovascular Surgery Saint Petersburg, Florida, U.S.A. Patient Selection Figure 1. The typical appearance of a pectus excavatum deformity. Pectus excavatum, a relatively commonly occurring congenital chest wall deformity in children, is a depression of the sternum that commonly starts at the angle of Louis, and is deepest at the xiphisternal junction [1] (Figure 1) . When severe, pectus excavatum deformity can cause cardiopulmonary insufficiency from the compression of the right atrium and right ventricle and diminished vital capacity of the lungs [1]. A variety of techniques are available to repair pectus excavatum deformity. The classic open surgical repair of pectus excavatum (the Ravitch repair) entails subperichondrial resection of the deformed cartilages and a sternal osteotomy [2], often combined with retrosternal support with a metal bar [3, 4, 5]. Three other pectus excavatum repair techniques include sternal turnover, unilateral costoplasty, and silicone implant reconstruction. Operative Steps Figure 2.

29. Lorenz Surgical - Pectus Excavatum craniofacial oral maxillofacial pectus neurosurgicalplastic surgery surgical instruments. http://www.lorenzsurgical.com/pectus.html

30. Pectus Excavatum pectus excavatum Funnel Breast. Trichterbrust. Book, Home Page. http://www.fpnotebook.com/LUN56.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Pulmonology Examination Airway ... Vital Capacity Assorted Pages Kussmaul Respiration Pectus Carinatum Pectus Excavatum Sputum Collection ... Purulent Sputum Pectus Excavatum Funnel Breast Trichterbrust Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Pulmonology Index Airway Alveoli Apnea Asthma Bacteria Bronchi Chronic Obstructive Pulmonary Disease Cardiovascular Medicine Emergency Medicine Examination Failure Fungus Gastroenterology Hematology and Oncology Infectious Disease ILD Laboratory General Obstetrics Pediatrics Pharmacology Pleura Prevention Procedures Radiology Rheumatology Sports Medicine Symptom Evaluation Tb Page Examination Index Airway Croup Score Apnea Malantatti Score Breathing Kussmaul Chest Pectus Carinatum Chest Pectus Excavatum ER Pneumothorax Coin Test ER Pneumothorax Succussion Splash Lab Lung Volume Lab Lung Volume FRC Lab Lung Volume VC Sputum Sputum Gross Sputum Microscopy Sputum Results Hemoptysis Sputum Results Purulent Epidemiology Incidence : 0.5 to 2%

31. Virtual Hospital: The International Thoracic Teaching Resource: Congenital: Pect pectus excavatum. pectus excavatum icon gif (2) Leftward displacement of the heartwith an upturned apex simulating right sided ventricular hypertrophy. http://www.vh.org/adult/provider/radiology/ITTR/PectusExcavatum/PectusEx.html

For Providers The International Thoracic Teaching Resource: Congenital Pectus excavatum Jeffrey R. Galvin, M.D.; Michael P. D'Alessandro, M.D.; Yasayuki Kurihara, M.D. Peer Review Status: Internally Peer Reviewed Clinical Sx: A common deformity of the sternum, also known as "funnel chest". The anteroposterior diameter of the chest is foreshortened by the depressed sternum. The majority of the patients are free of symptom. The incidence in the general population is 0.13-0.4%. Etiology/Pathophysiology: It is generally believed that pectus excavatum results from a genetically determined abnormality of the sternum and related portion of the diaphragm. Pathology: Miscellaneous: Imaging: The Chest radiograph of the patients with pectus excavatum sometimes shows several interesting radiologic findings which might result in misinterpretation. They are as follows: (1) Increased opacity in the right inferomedial lung field with obscuration of the right heart border mimicking atelectasis or pneumonia of the right middle lobe. (2) Leftward displacement of the heart with an upturned apex simulating right -sided ventricular hypertrophy.

32. Virtual Children's Hospital: Correlapaedia - A Correlative Encyclopedia Of Pedia Chief Complaint Sixteen year old male with a pectus excavatum deformityof the chest. Clinical Physical Exam Severe pectus excavatum. http://www.vh.org/pediatric/provider/radiology/CAP/Case47/Case47.html

Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology Case 47 Michael P. D'Alessandro, M.D., Steven J. Fishman, M.D., Deborah E. Schofield, M.D. Peer Review Status: Internally Peer Reviewed Chief Complaint: Sixteen year old male with a pectus excavatum deformity of the chest. Clinical History: The patient was a 16 year old male with a severe pectus excavatum deformity. Clinical Physical Exam: Severe pectus excavatum. Images 1, 2, and 3 Clinical Labs: Non-contributory Clinical Differential Diagnosis: Pectus excavatum Imaging Findings: No preoperative imaging was performed. Imaging Differential Diagnosis: Pectus excavatum Operative Findings: The patient underwent a Welch repair of pectus excavatum over a retrosternal Adkin's bar. Pathological Findings: None Final Diagnosis: Pectus Excavatum Follow-up and Prognosis: The patient had an uncomplicated post-operative course. The Adkin's bar was removed 7 months after placement. Image 4 Similar Cases: None References: Paediapedia Title Page See related Provider Textbooks about Pathology Radiology or Surgery See related Provider Topics Diagnostic Imaging Laboratory Tests Pathology Procedures and Therapies ... Surgeries or Surgery See related Patient Textbooks about or Radiology See related Patient Topics Diagnostic Imaging Laboratory Tests Procedures and Therapies Radiology or Surgeries Virtual Children's Hospital Home Virtual Hospital Home Site Map ... UI Health Care Home http://www.vh.org/pediatric/provider/radiology/CAP/Case47/Case47.html

33. MEDLINEplus Medical Encyclopedia: Pectus Excavatum pectus excavatum. Considerations Return to top pectus excavatum isa congenital abnormality that can be mild or fairly marked. The http://www.nlm.nih.gov/medlineplus/ency/article/003320.htm

Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Pectus excavatum Contents of this page: Illustrations Alternative names Definition Considerations ... What to expect at your health care provider's office Illustrations Pectus excavatum Ribcage Pectus excavatum repair - series Alternative names Return to top Funnel chest Definition Return to top The descriptive term for an abnormal formation of the rib cage where the distance from the breastbone (sternum) to the backbone (vertebrae) is decreased, resulting in a caved-in or sunken chest appearance. Considerations Return to top Pectus excavatum is a congenital abnormality that can be mild or fairly marked. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep. It is caused by excessive growth of the costosternal cartilage (the connective tissue joining the ribs to the breastbone), with resulting inward deformity of the sternum. If pectus excavatum is severe, it may affect the underlying organs (heart and lungs) leading to exercise intolerance or other problems. In addition, the cosmetic appearance of a pectus excavatum may pose a psychological difficulty. Pectus excavatum may occur as the only abnormality, or in association with other syndromes.

34. MEDLINEplus Medical Encyclopedia: Pectus Excavatum Medical Encyclopedia. pectus excavatum. pectus excavatum is a condition inwhich the breast bone (sternum) appears sunken and the chest concave. http://www.nlm.nih.gov/medlineplus/ency/imagepages/2927.htm

Skip navigation Medical Encyclopedia Pectus excavatum Pectus excavatum is a condition in which the "breast bone" (sternum) appears sunken and the chest concave. It is sometimes called "funnel chest". The majority of these cases are not associated with any other condition (isolated findings). However, some syndromes include pectus excavatum. Health Topics Drug Information Encyclopedia Dictionary ... National Institutes of Health Page last updated: 10 January 2003

35. EMedicine - Pectus Excavatum : Article By Andre Hebra, MD pectus excavatum pectus excavatum, also known as sunken chest, is a congenitalchest wall deformity in which several ribs and the sternum grow abnormally http://www.emedicine.com/ped/topic2558.htm

document.write(''); (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Pediatrics Pulmonology Pectus Excavatum Last Updated: November 8, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: sunken chest, congenital chest wall deformity, pectus, Marfan syndrome, Poland syndrome, minimally invasive repair of pectus excavatum, MIRPE, Nuss technique, open Ravitch technique for repair of pectus excavatum AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Andre Hebra, MD , Clinical Associate Professor of Surgery, Department of Surgery, University of South Florida, All Children's Hospital Andre Hebra, MD, is a member of the following medical societies: Alpha Omega Alpha American Academy of Pediatrics American College of Surgeons American Medical Association ... Southeastern Surgical Congress , and Southern Medical Association Editor(s): Girish Sharma, MD

36. The Pectus Excavatum Listserve Trainer Joe. This site has been created for the timely disseminationof information related to pectus excavatum and Pectus Carinatum. http://groups.msn.com/ThePectusExcavatumListserve

MSN Home My MSN Hotmail Search ... Money Groups The Pectus Excavatum Listserve ThePectusExcavatumListserve@groups.msn.com Groups Home My Groups Language Help ... Tools SPONSORED SITES: Recommend This Group to a Friend New Messages View all Dr. Edward Tagge Dr. Edward Tagge Medical University of South Carolina Charleston, SC 1-800-424-6872 taggeed@musc.edu... MomC Sounds GREAT!!! If I can help, let me know!! Heather ... jvksmom 2 weeks post leonarde I have recently noticed my upper pe is not 100% corrected i still have a low spot from just above my nipple to my clavical not bad though i should be able to gain some weight and work out to fill... jasper ONLY TRAINER JOE RESPONDED Evalisa,In response to your question. My daughter had a dent (PE) with flared ribs. I didn't have a dent (PE) but flared ribs. She had flared ribs since birth and PE shortly after. Her symptom... Deli Tools Join This Group Recommend This Group ... Group Settings New Photos View all jasper jasper post op ... jasper Albums with New Photos jaspers pe MDSHOF Knick's PE pic Pectus Heroes Photo Album Notice: Microsoft has no responsibility for the content featured in this Group. Click here for more info.

37. 1Up Health > Pectus Excavatum > Common Causes Of Pectus Excavatum (Funnel Chest) Comprehesive information on pectus excavatum (Funnel chest). pectus excavatum Common Causes. Alternative names Funnel chest. Definition http://www.1uphealth.com/health/pectus_excavatum_info.html

1Up Health Symptoms Guide Pectus excavatum Alternative Medicine ... Health Topics A-Z Search 1Up Health Symptoms Guide Pectus excavatum Information Pectus excavatum : Common Causes Alternative names : Funnel chest Definition : The descriptive term for an abnormal formation of the rib cage where the distance from the breastbone (sternum) to the backbone (vertebrae) is decreased, resulting in a caved-in or sunken chest appearance. Common Causes Isolated defect (i.e., not associated with other problems) Familial pectus excavatum Marfan's syndrome Rickets Previous Next Jump to Another Section of this Guide Definition Common Causes Considerations Call your Health Care Provider if What to Expect at your Health Care Provider's Office Related Tools and Utilities Search Books on Amazon: Read Articles on eLibrary: Health Products on drugstore.com: Review Date Reviewed By : Adam Ratner, M.D., Children's Hospital of Philadelphia, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Guide Definition Common Causes Considerations Call your Health Care Provider if What to Expect at your Health Care Provider's Office More Info ...

38. 1Up Health > Pectus Excavatum Repair > Description (Chest Deformity Repair, Funn . Alternative names......Comprehesive information on pectus excavatum repair (Chest deformity repair, Funnelchest repair). pectus excavatum repair http://www.1uphealth.com/health/pectus_excavatum_repair_info.html

1Up Health Pectus excavatum repair Alternative Medicine Clinical Trials ... Health Topics A-Z Search 1Up Health Pectus excavatum repair Information Pectus excavatum repair : Description Alternative names : Chest deformity repair, Funnel chest repair Definition : Surgery to correct pectus excavatum , a deformity of the front of the chest wall with depression of the breastbone (sternum) and rib (costal) cartilages. Description While the child is deep asleep and pain-free (using general anesthesia), an incision is made over the breastbone (sternum). The deformed cartilages are removed and the rib lining is left in place to allow regrowth of the cartilages. An incision is made in the sternum and it is repositioned. A rib or metal strut may be used to stabilize the sternum in normal position until healing occurs in 3 to 6 months. A temporary chest tube may be placed to reexpand the lung if the lining of the lung is entered. Metal struts are removed 6 months later through a small skin incision under the arm. This procedure is usually done on an outpatient basis. Most repairs are done between 18 months and 5 years of age. Previous Next Jump to Another Section of this Guide Definition Description Indications Expectations after Surgery Convalescence and Recovery Risks Related Tools and Utilities Search Books on Amazon: Read Articles on eLibrary: Health Products on drugstore.com:

39. PECTUS EXCAVATUM pectus excavatum. What is pectus excavatum? This term refers to a chest usuallythe right. What causes pectus excavatum? The cause is http://www.cardiothoracicsurgery.wustl.edu/healthinfo/Pectus excavatum web.htm

PECTUS EXCAVATUM What is Pectus Excavatum? This term refers to a chest wall deformity resulting in the breast bone (sternum) being sunken in. It is sometimes referred to as “funnel chest”. It usually involves the lower half of the sternum. Although it is most common in the middle of the chest, it may move over to one side, usually the right. What causes Pectus Excavatum? The cause is unknown, although most children with this have had it since birth or early infancy. I suspect it occurs as a result of discoordinated growth between the ribs and the chest in general. If the ribs grow faster than the expansion of the heart and lungs (which push the sternum outward) then the sternum will be pushed inwardly. Once this has occurred, the deformity either stays the same or gets worse. What effect does Pectus Excavatum have on the heart and lungs? For normal day-to-day activities there is no impact on heart or lung function. Most children will have lung capacity that is slightly below average, but still within what is considered a normal range. However, the ability of the heart to pump effectively during strenuous exercise may not be normal.

40. Progress Notes Update - Pectus Excavatum Update on Minimally Invasive Surgical Repair of pectus excavatum. AThis is ahuge improvement over the standard open operation for pectus excavatum.@. http://www.muschealth.com/Pnotesupdate/pectus.htm

Update on Minimally Invasive Surgical Repair of Pectus Excavatum Pectus excavatum, more commonly called funnel chest, is a congenital problem in which the anterior chest wall is displaced backward, as if it were A caved in. Chronic chest pain and reactive airway disease are frequently seen in conjunction with this abnormality. Occasionally, patients will experience respiratory, circulatory or digestive problems. In addition, the disfiguring physical appearance of this abnormality can have an enormous impact on a child s emotional and social development. Surgical correction is generally indicated. The standard open surgery for repair of pectus excavatum is an extensive operation that produces good results. Depending on the patient s age, the repair can take up to six hours to perform and occasionally requires blood transfusion. The postoperative stay averages about one week, and management of postoperative pain can be complex. For approximately two years, Drs. Andre Hebra and Edward Tagge , pediatric surgeons at MUSC Children s Hospital, have used a new minimally invasive technique to manage the repair. Originated by Donald Nuss, M.D., of Norfolk, Va., the surgery involves only two small incisions on either side of the chest wall. Overall results have been excellent. The technique results in shorter hospital stays and faster recovery times.

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