Chest Wall Program

What to Expect

Your child will initially see one of the pediatric surgeons at any of our conveniently-located outpatient clinics throughout Indiana. After a thorough history and physical examination, you and your child will meet with your child’s surgeon to plan the next steps which may be observation, non-operative management strategies or scheduling a surgery to correct the abnormality.

Diagnostic testing and studies for chest wall abnormalities include:

• CT scan of the chest. This test is used to evaluate the depth and severity of pectus excavatum.
• Pulmonary function testing. Used in some cases to determine whether your child's lung function is affected by the chest wall abnormality.
• Echocardiograph. This test is used to evaluate the function of your child's heart.

Treatment Options

The treatment options available to your child depends on the type of chest wall abnormality:

• Pectus excavatum: In children with pectus excavatum, treatment options include surgical repair using minimally invasive thoracoscopic repair (Nuss procedure) or open repair (Ravitch procedure).
• Pectus carinatum: For children with pectus carinatum, treatments include non-operative correction with a brace or open repair surgery (Ravitch procedure).
• Other chest wall abnormalities: In children with Poland syndrome and other chest wall abnormalities, procedures are tailored to the severity and type of condition.

If your child’s treatment includes surgery, we want to optimize your child’s recovery process. We may place an epidural catheter (long narrow tube) placed near the spine in the upper back where we will use medication to control pain. Another option for pain control after chest surgery is cryoablation. This is a process where the surgeon will freeze some of the nerves between the ribs on each side of the chest. This will result in decreased pain sensation in the chest and pain control for your child. The effects of cryoablation usually last between 2 to 3 months. Cryoablation has been found to be safe and effective for improving pain control and shortening hospital stay.