Chest Wall Specialist

Rockland Thoracic & Vascular Associates

Thoracic Surgery & Vascular Surgery located in Pomona, NY & Goshen, NY

The problem most likely to affect your chest wall is pectus excavatum, also called sunken or funnel chest. If you’re having problems breathing when you exercise because of your sunken chest, the experienced doctors at Rockland Thoracic & Vascular Associates can help. They have considerable experience in treating chest wall conditions like pectus excavatum, including doing advanced forms of video-assisted thoracoscopic surgery (VATS). The practice has offices in Washington Heights, Manhattan, in New York City; Pomona, Goshen, and Fishkill, New York; and Englewood, New Jersey. Call your nearest office today or book an appointment online.

Chest Wall Q & A

What conditions affect the chest wall?

The main condition affecting the chest wall is pectus excavatum, which makes your chest look sunken or caved in.

Pectus excavatum is a congenital condition, meaning you’re born with it. The condition causes your sternum (breastbone) and some of your ribs to grow abnormally, so your chest wall sinks. 

Pectus excavatum is quite common, affecting men more often than women. It also runs in families.

Pectus excavatum isn’t always present when you’re born. It can come on later, during puberty. It’s not clear exactly what causes pectus excavatum, but it seems to be an overgrowth of cartilage that pulls your breastbone in.

What problems does pectus excavatum cause?

Pectus excavatum can affect your heart and lungs. The shape of your chest wall might mean there’s a lack of room for your lungs to expand, causing:

  • Fatigue
  • Shortness of breath
  • Chest pain
  • Fast heartbeat

Your breastbone could also be too close to the main artery in your lungs (pulmonary artery), causing a heart murmur.

How is a chest wall condition diagnosed?

Your provider at Rockland Thoracic & Vascular Associates diagnoses your chest wall condition by examining you and reviewing your medical history and symptoms.

Diagnostic tools they can use include:

  • Heart sound analysis
  • Electrocardiogram (ECG or EKG)
  • Echocardiogram
  • Pulmonary function testing
  • Chest X-ray
  • CT scan

Your provider can measure the severity of a chest wall condition like pectus excavatum using a calculation called the Haller Index. 

The calculation uses ratios and distances of your chest wall anatomy from a CT scan. A normal Haller Index is 2.5. A severe case of pectus excavatum would have a Haller Index higher than 3.25.

How are chest wall conditions treated?

The team at Rockland Thoracic & Vascular Associates can operate on chest wall conditions like pectus excavatum to restore more normal anatomy. 

Surgery often involves realigning your breast bone to create more room for your lungs and heart. While it’s better to have surgery at a younger age — ideally between 12 and 18 — surgery can work for adults too.

The traditional surgical technique for pectus excavatum is the modified Ravitch repair. This is an open surgery that involves removing some of the abnormal cartilage, repositioning the ribs and breastbone, and reinforcing the chest wall with titanium bars.

A minimally invasive approach called the Nuss procedure is also available. The team at Rockland Thoracic & Vascular Associates use video-assisted thoracoscopic surgery (VATS) to create a passage under your breastbone. They then fit a customized Lorenz pectus bar that guides the chest wall to grow into a more correct position.

Some patients might be suitable for uniportal video-assisted thoracic surgery (Uni-VATS), which requires only one incision.

If you’d like to find out more about treatment for chest wall conditions like pectus excavatum, call Rockland Thoracic & Vascular Associates today or book an appointment online.