Pectus Treatment Program

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As a leading provider for pectus care, our pectus treatment program provides your child with the best possible outcomes. Our experienced pediatric chest wall experts use leading-edge procedures focused on reducing recovery time. That way, your child will be back to doing what they love as soon as possible.

Chest Wall Conditions We Treat

Our pectus treatment program provides care for two chest wall conditions.

  • Pectus Excavatum is commonly known as “funnel chest.” This occurs when a person’s breastbone is sunken inward, leaving a dent in their chest. The sunken breastbone can be seen shortly after birth or more commonly around puberty. This condition will typically worsen as your child grows. Children with funnel chest can experience shortness of breath, heart palpitations, chest pain, dizziness and more. More severe cases may interfere with the function of the heart. Severe cases often require corrective surgery.
  • Pectus Carinatum is also referred to as “pigeon chest.” It occurs when a child’s breastbone and ribs protrude outward. At times, the condition is not identified until after a growth spurt. It typically does not cause complications beyond the chest bulge. However, it can sometimes lead to chest discomfort. Most children will only require a brace to correct pectus carinatum

Innovative Pectus Treatment at CHOC

CHOC’s pectus excavatum program brings together a multidisciplinary team of pediatric experts. Your child’s pectus treatment team include pediatric pulmonologists, cardiologists, pediatric anesthesiologists, pediatric thoracic surgeons and patient mentors. Our program sets the standard in treatment safety and efficacy by assigning two surgeons to every case. Additionally, our cutting-edge pectus excavatum surgery, the Nuss Procedure, allows around 65% of patients to be discharged from the hospital the same day as their surgery. Our specialized focus on pain management during and after surgery gets kids back to enjoying their childhood as quickly as possible.

Leader in Pectus Excavatum Surgical Treatment

Dr. Mustafa Kabeer, a pediatric general surgeon at CHOC, is one of the few surgeons in the region who performs the Nuss Procedure. He is at the forefront of developing innovative ways to treat patients with pectus excavatum. Dr. Kabeer combines advanced surgical techniques along with a paravertebral block and cryoablation, to significantly reduce pain after surgery. This improved pain management allows for quicker discharge and at-home recovery.

Coordinated Pectus Patient Care at CHOC

Going through surgical procedures can be overwhelming. That is why CHOC programs are dedicated to supporting families every step of the way. Our pectus program coordinator, Jacqueline Hurley, will guide families and pectus patients through the treatment process. She helps arrange all medical care, travel plans, appointments and more – she is a complete resource. Thanks to Jacqueline, families at CHOC’s Pectus Treatment Program receive unmatched individualized care.

Pectus Family Mentorship Program

To further support patient care, CHOC offers a pectus family mentorship program. The program connects past pectus patients with new patients to assist families through the process. The mentorship program is offered to all patients regardless of surgery status.

Planning Your Visit

CHOC can be a destination hospital for families across the country. In addition to the expert team and services for pectus treatment, we offer family amenities and resources to make your trip comfortable. If you are traveling from out of town and need support in planning your visit, the Pectus Treatment Program team is here to help. Check out what CHOC offers for your stay.

Pectus Treatment Program: What to Expect

Here is the journey you and your child can expect for pectus treatment at CHOC.

  1. You will start with a consultation from one of CHOC’s three pectus surgeons. A child’s pediatrician typically refers patients. In this consultation, the surgeon will assess your child’s pectus condition and determine if surgery is necessary. If your child is diagnosed with pectus carinatum, they will be referred to orthotics (Pectus Jo) for chest bracing.
  2. If your child is diagnosed with pectus excavatum and qualifies for surgery, they will undergo pre-operative testing. These tests can include:
  1. After testing, you will have another appointment with your child’s treatment team to review the results. After this review, your family will decide whether to proceed with pectus excavatum surgery
  2. If surgery is chosen, Jacqueline, our pectus program coordinator, will work with your family to schedule the procedure and the necessary steps. In most cases, surgery is not an emergency, so timelines can accommodate what is best for your family.
  3. Finally, your child will undergo their Nuss procedure, where 65% of patients are sent home the same day for recovery.
  4. Patients receive an at-home exercise guide for patients after surgery. However, if additional outpatient rehabilitation services are required, your child will be referred to CHOC’s program or to one closer to your home, if traveling from out of state.

Multidisciplinary Team of Pectus Experts

Your child’s pectus treatment team can include:

The various pediatric experts at CHOC will work together to develop an individualized treatment plan for your child. Through our program, your child will be provided with the exact care they need at the right time. 

Expansive Network of Pediatric Specialists

Connective tissue disorders are commonly diagnosed in children with pectus excavatum. If your child needs treatment for a co-occurring condition, Jacqueline, our pectus program coordinator, will help set up any other consultations. If your child has a connective tissue disorder, they will be referred to CHOC’s genetic services.

Request a consultation

While not all pectus cases require surgery, CHOC is here to evaluate on a case-by-case basis. If you are not sure whether your child needs specialty care, it is best to be seen by a pectus treatment expert.

Submit a form to schedule a consultation with a CHOC pectus expert.

Pectus Treatment Program FAQs

What age is best to have a Nuss procedure?

The repair of pectus excavatum with a minimally invasive Nuss procedure has the best results when done between the ages of 12 and 15 years but are often performed on patients between 15-20.

How do I know if I am a candidate for a Nuss procedure?

If you have pectus excavatum (sunken chest), we will ask you to have three tests to determine if you are a candidate for a NUSS procedure. These include a cardiac MRI scan of the chest with a Haller index, a pulmonary consultation with lung function studies, and a cardiology consultation that includes a cardiac ECHO, EKG and CPX.

Is a Nuss procedure painful?

The operation does involve some pain but is minimized by our unique combination of multimodal pain management that is so effective that 65% of our patients go home the same day. We offer cryoablation which is a very new technique for pain control.

How long will my child’s recovery be?

We expect recovery to last for approximately two weeks, with minimal activity during that time.

When can my child get back to normal activities, especially sports?

The first four to six weeks after surgery are critical for healing. After six weeks, children may start doing cardiovascular exercises and lower body strengthening. After three months, most sports may resume.

How many Nuss procedures has CHOC done?

The pediatric surgeons at CHOC have done more than 300 successful Nuss procedures.

What are the biggest risks or complications that can occur from the Nuss procedure?

There are two possible complications that can occur. One is bar migration, and the other is infection. Learn more about the Nuss Procedure at CHOC.

How long has CHOC been doing this minimally invasive Nuss procedure?

Our CHOC pectus surgeons have been doing the Nuss procedure since 2001 with a very high patient satisfaction and success rate.

Meet the Pectus Treatment Program Team

  • Dr. Pierangelo Renella is board-certified in pediatrics and pediatric cardiology. He sub-specializes in advanced cardiovascular imaging and fetal cardiology.
  • Dr. Sunil Kamath specializes in pediatric pulmonology and is the medical director of Respiratory, Pulmonary, and Blood Gas Services at CHOC.
  • Dr. Joseph Kim is a board-certified anesthesiologist who provides care for infants and children undergoing anesthesia.
  • Dr. Mustafa Kabeer is a board-certified pediatric surgeon at CHOC, performing all types of general surgery and specializing in pectus excavatum, lung resection, hernia and robotic surgery.
  • Dr. Troy Reyna is a board-certified pediatric surgeon at CHOC, specializing in pectus excavatum, hernias and hyperhidrosis.
  • Dr. Laura Goodman is a pediatric general and thoracic surgeon who performs surgery on children and adolescents.
  • Nurse Practitioners: Melisa Hill, Rebecca John, Lauren Kanamori
  • Pectus Coordinator: Jacqueline Hurley