How is pectus carinatum treated?
If the condition is causing symptoms, there are two treatment options: bracing and surgery.
Bracing for pectus carinatum works similar to the way braces work on teeth. The brace is worn around the chest and provides pressure from both the front and back to move the breastbone back to its usual position. The child wears the brace for a minimum of eight hours per day, sometimes longer, for at least six months. The brace can be removed for showering, sports, and other activities.
Surgical correction for pectus carinatum involves a technique called the Ravitch Procedure. This procedure is completed with an incision (cut) in the mid-chest area to remove anterior (in the front) cartilage. Stainless-steel struts are placed across the anterior chest to support the breastbone and are wired to the appropriate ribs on each side, allowing the breastbone to be elevated. The struts are not visible from the outside and are removed later during a surgical procedure.
What are the risks of correction of pectus carinatum?
Bracing treatment for pectus carinatum is very safe. A small number of patients may have irritation or breakdown of the skin where the brace makes contact. Patients are taught to stop using the brace at the first sign of any irritation. They are then asked to return to the office so that the brace can be adjusted.
The surgical repair of pectus carinatum, like other extensive surgeries, carries certain risks. While the Ravitch Procedure is also safe and effective, complications can occur, including:
- Pneumothorax (an buildup of air or gas in the pleural space around the lung)
- Pleural effusion (fluid around the lung)
- Pericarditis (inflammation around the heart)
- Bar displacement
- Pectus carinatum recurrence (return)