Nuss Center FAQ

Yes. The most widely used corrective surgery for Pectus Excavatum is the Nuss Procedure, a groundbreaking treatment developed right here at CHKD.

Typically, pediatric general/thoracic surgeons, or adult thoracic surgeons, who have been trained in pectus surgeries like the Nuss procedure will do pectus excavatum repairs. There is an “open” procedure called a Ravitch procedure that is more invasive and used much less.

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The Nuss procedure can be performed at any age but ideally around puberty, and usually not before 10 years of age. The median age of our patients is 15 years old.

The median age of patients receiving the Nuss Procedure at CHKD is 15.

When the Haller index or the Correction index is higher, these are considered more severe cases of pectus excavatum. The Haller index is a pectus excavatum severity score using CT scans.

The Nuss procedure, despite being a minimally invasive surgery, can be a painful surgical procedure. There are several strategies used to optimize postoperative pain control in this population.

Pain management after the Nuss procedure at CHKD.

At experienced centers like CHKD, the risks of complications with this procedure are very low.

Yes. CPR can be performed with the Nuss bars in place. More force is recommended. A medical bracelet or necklace is recommended.

Pectus hardware can shift or move after surgery, but this is rare. Depending on the severity and timing, pectus hardware may need to be repositioned.

Typically, it does not. Pectus excavatum is different for each person with the diagnosis. The only way someone may be disqualified from military service would be due to symptoms of the condition, such as exercise intolerance due to compression of the heart and or lungs.

The Nuss Procedure, as with any medical procedure, comes with a risk of failure or complication. The failure rate of the Nuss Procedure performed at CHKD is less than 1%.

View our outcome data here.

Some patients have experienced complications requiring the surgery to be redone. Although this is very rare for CHKD surgeons, it is possible.

You can live a long normal life with pectus excavatum. As one might imagine, a severe case of pectus excavatum could impact lung and heart function that could result in other conditions that may impact performance.

Learn more about the patient experience at CHKD's Nuss Center. 

Typically, the deformity will get worse in younger patients and stay about the same in older patients.

Pectus Excavatum is not known to cause heart failure.

The vacuum bell is an alternative to surgical treatment for the condition. The device acts like a suction cup on the chest. The surgeons will recommend how often to wear the device, at what pressure and how many months or years.

The typical stay following the Nuss Procedure averages 3 days.

The Nuss procedure performed at Children’s Hospital of the Kings Daughters is considered inpatient. The typical stay will be a little over 3 days.

You will have restrictions typically up to three months after the Nuss Procedure. Our program will review the details of this at the time of consultation.

Physical improvement following pectus surgery has been documented extensively. Patients have also consistently reported improved self-image and greater physical capacity.

Former patient Chris Baione shares how having the Nuss procedure at CHKD helped him gain the confidence he always wanted. See his story below.

Almost all patients who have chest wall surgery report an improved self-image.

Hardware is placed in the chest in such a fashion that it elevates the sternum to a more normal position.

We are not familiar with anyone qualifying for disability services due to a diagnosis of pectus excavatum or carinatum. Although pectus conditions may contribute to a disability, that disability qualification would be the result of another diagnosis.

Surgeons at the Nuss Center have a long history of success helping patients with some of the most complicated situations.

Yes, but there are also nonoperative approaches that we offer.

This type of procedure can be more complex than a standard pectus excavatum repair. We recommend you find a very experienced pectus surgeon who has completed this surgery successfully in the past. Surgeons at the Nuss Center are often asked to work on complicated cases and to repair prior surgeries.

In recent history, some insurance carriers have paid for the device in full or in part as durable medical equipment.

Insurance coverage for the therapies we offer can vary widely. We always recommend that the owner of the policy call and enquire about coverage directly. Some insurance companies request specific diagnosis codes or equipment codes in order to give an estimate of coverage. The Nuss Center staff and provide the codes as needed.

Some pectus conditions are covered by health insurance. Some treatment modalities such as braces may also be covered. This will vary widely based on the insurance policy one owns.

Insurance will cover repair of pectus excavatum as a medically necessary procedure. Some insurance companies are using evermore strict criteria to determine what they deem medically necessary. In some cases, they will demand additional testing.