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 somecases, 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.
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