The Ravitch Procedure

What Is the Ravitch Procedure?

The Ravitch procedure is a surgery to correct severe pectus carinatum and pectus excavatum. It's typically used for patients 13 to 22 years old.

What Are Pectus Carinatum and Pectus Excavatum?

Pectus carinatum is a condition in which the sternum (breastbone) juts out. Pectus excavatum is when the breastbone is caved in. These conditions happen because several ribs and the breastbone grow abnormally.

Pectus carinatum and pectus excavatum can be mild or severe. Severe cases may cause problems with the heart and lungs.

What Happens During the Ravitch Procedure?

The Ravitch procedure has several steps. The surgeon:

1. Makes an incision across the chest.
2. Repairs or reshapes the sternum.
3. In some cases, places one or more bars to keep the sternum in its new position. They're removed after about 6 months.
4. Places one or more drains under the skin to drain fluid from the surgery site.
5. Might place a chest tube to prevent the lung from collapsing.
6. Closes the incision.

In the months after surgery, the cartilage grows and keeps the sternum in its new position.

What Happens After the Ravitch Procedure?

After surgery, kids need pain medicine and rest. They should stay home from school until they no longer need to take prescription pain medicine. Doing breathing and other exercises as recommended by the surgeon help with recovery.

For a few months, kids also should:

• avoid gym class at school
• not carry a backpack or other heavy bag
• avoid strenuous activity, including running
• not drive
• ride in the back seat of cars to avoid possible trauma from an air bag
• not play sports that could cause injury to the chest (such as football, soccer, and baseball)

It may take 6 months or more for kids to safely return to all the activities they did before the surgery.

Are There Any Risks From the Ravitch Procedure?

There are risks with any surgery, including bleeding, infection, and problems with anesthesia.

Specific risks for the Ravitch procedure include:

• pain that can last a month or more
• fluid collection under the skin at the surgery site
• fluid around the lung or a collapsed lung
• bars that move out of place
• damage to the heart or lungs during surgery
• pectus excavatum or pectus carinatum that comes back

What Else Should I Know?

Pectus carinatum or pectus excavatum can make kids feel self-conscious about the way they look. The Ravitch procedure can improve the way the chest looks and help a child's self-esteem. The recovery time can be difficult, but most kids are happy with the results.