Surgical solution: A fix for sunken chests

This X-ray shows a surgically inserted metal bar that will help to correct a sunken chest, a somewhat rare condition.

This X-ray shows a surgically inserted metal bar that will help to correct a sunken chest, a somewhat rare condition..

Upstate thoracic surgery chief Jason Wallen, MD, offers surgery to repair sunken chests, a somewhat rare condition some people are born with called pectus excavatum.

Those affected may be self-conscious and also have trouble breathing.

“It’s not felt to be due to compression of the lungs as much as it is from compression of the heart,” the surgeon explains. “Heart trouble can cause people to have the symptom of difficulty breathing.”

Surgery can lead to permanent improvement.

Jason Wallen, MD

Jason Wallen, MD

The procedure is almost always done with small incisions, one on either side of the rib cage. “It involves placing a bar across the chest underneath the sternum, to lift it up and cause it to be nearly flat or completely flat,” Wallen describes. The bar provides structural support while bone and cartilage remodel to provide natural support (see the X-ray above).

Wallen says he places two small holes in the sternum (breastbone) so that he can secure the bar to the underside of the sternum with sutures. This is meant to prevent the bar from slipping. The bar — made of stainless steel or titanium — stays in place for two or three years before it is removed.

Surgery takes a couple of hours, followed by a three- or four-day hospital stay. “There is some soreness,” Wallen acknowledges, “so we utilize a number of different pain medications to make sure the patient is comfortable in the short term.”

Patients are encouraged to get up and around as soon as they feel able. After a recovery of four to six weeks, Wallen says they can usually return to all activities, including contact sports.

To learn more about treatment for pectus excavatum, contact Upstate’s thoracic surgery clinic at 315-464-1800.

Upstate Health magazine spring 2018 cover

Upstate Health magazine spring 2018 cover

HealthLink on Air logoThis article appears in the spring 2018 issue of Upstate Health magazine. To hear a podcast where Wallen describes the sunken chest and its repair in more detail, click here.

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