My Chart

Presbyterian Heart and Vascular Care Providers

We have a highly skilled team who can provide a wide range of services from diagnosis to treatment.

Find a Provider

Nuss Procedure

The Nuss procedure is a surgery to correct severe pectus excavatum, a condition in which the breastbone (sternum) of the chest is caved in. Pectus excavatum is typically noticed at birth, and more than two-thirds of cases are diagnosed within the first year of life.

This procedure is considered less invasive than open-chest surgery because only a few small incisions (cuts) are needed.

The surgeon makes two small cuts in the side of the chest, places one or more steel bars behind the breastbone, and attaches them to the ribs' outer edge. This raises the breastbone. The chest reshapes after about two to four years. The bars are later removed.

Why choose Presbyterian for your Nuss procedure?

Presbyterian Heart and Vascular Care has a team of highly-skilled surgeons who are using some of the most advanced techniques to perform this procedure. These techniques can improve recovery time, reduce complications and provide a quicker return to work and other daily activities.

Who is eligible for a Nuss procedure?

Worsening of the chest’s appearance and the onset of symptoms, usually during puberty, may determine eligibility. Possible symptoms include:

  • Fatigue.

  • Dizziness.

  • Chest pain.

  • Heart murmur.

  • Wheezing or coughing.

  • Decreased exercise tolerance.

  • Recurrent respiratory infections.

  • Rapid heartbeat or heart palpitations.

What conditions can be treated with a Nuss procedure?

The condition treated by the Nuss procedure is pectus excavatum.

How do I prepare for a Nuss procedure?

To avoid discomfort due to constipation after surgery, start your child on a gentle laxative regimen two days before surgery.

Your child may be given an incentive spirometer (a device used to help keep the lungs healthy after surgery) to practice deep breathing exercises before surgery. Please have your child use the incentive spirometer twice daily as directed until the surgery date and upon returning home from surgery.

You will be given antiseptic wipes to clean your child’s chest the night before the procedure and the morning of surgery to help reduce the risk of infection.

What should I expect during the Nuss procedure?

The Nuss procedure has several steps:

  1. The surgeon makes two small cuts in the side of the chest.

  2. The surgeon places one or more steel bars behind the breastbone and attaches them to the ribs' outer edge. The surgeon uses a tiny camera to get the bars in the right place.

  3. The surgeon turns the bars, raising the breastbone.

  4. A metal plate (called a stabilizer), sutures (stitches), or wire is placed to hold the bars in place.

The chest is fully reshaped after about two to four years. Then the surgeon removes the bars.

How do I care for myself after the Nuss procedure?

Even though the Nuss procedure is minimally invasive, your child will need pain medicine and rest after the surgery. He or she will need to stay home from school for about three weeks. It may take six months or more for your child to return to their regular activities.

For about six weeks after the surgery, your child should:

  • Not drive.

  • Avoid strenuous activity, including running.

  • Do all breathing exercises to prevent infection.

  • Walk or do other gentle exercises as recommended by the surgeon.

  • Ride in the back seat to avoid possible trauma from an airbag.

Your child should not play sports that could cause a chest injury (such as football, soccer, and baseball) until the surgeon says it's OK.