Pectus excavatum is a structural deformity of the anterior thoracic wall in which the sternum and rib cage are shaped abnormally.

People with the condition may experience severe negative psychosocial effects and avoid activities that expose the chest.

[5] In severe cases, the right atrium may be compressed, mitral valve prolapse may be present, and physical capability may be limited due to base lung capacity being decreased.

[6][7] Psychological symptoms manifest with feelings of embarrassment, social anxiety, shame, limited capacity for activities and communication, negativity, intolerance, frustration, and even depression.

A small sample size test found that in at least some cases, 37% of individuals have an affected first degree family member.

However, a 2016 meta-analysis found significant evidence that surgical correction of pectus excavatum improves patient cardiac performance.

The chest x-ray in pectus excavatum can show an opacity in the right lung area that can be mistaken for an infiltrate (such as that seen with pneumonia).

[20] Some studies also suggest that the Haller index can be calculated based on chest x-ray as opposed to CT scanning in individuals who have no limitation in their function.

[28] Non-surgical treatments have been developed that aim at gradually alleviating the pectus excavatum condition, making use of the elasticity of the chest wall, including the costal cartilages, in particular in young cases.

Physical exercise has an important role in conservative pectus excavatum treatment though is not seen as a means to resolve the condition on its own.

[35] Once the defect visually disappears, two additional years of use of the vacuum bell is required to make what may be a permanent correction.

[40] In an article by Interactive Cardiovascular and Thoracic Surgery, the results found that vacuum bell treatment is safe for correcting the deformity non-surgically.

The treatment has been shown to have higher success rates in patients who present earlier, have a mild and/or symmetrical deformity, a flexible chest wall and lack of costal flaring.

[44] Surgical correction has been shown to repair any functional symptoms that may occur in the condition, such as respiratory problems or heart murmurs, provided that permanent damage has not already arisen from an extremely severe case.

[49] One magnet is inserted 1 cm into the patient's body on the lower end of the sternum, the other is placed externally onto a custom fitted brace.

[49] The 3MP technique's main advantages are that it is more cost-effective than major surgical approaches such as the Nuss procedure and it is considerably less painful postoperatively.

Its effectiveness is limited to younger children in early- to mid-puberty because older individuals have less compliant (flexible) chest walls.

It is more often used in older individuals, where the sternum has calcified when the deformity is asymmetrical, or when the less invasive Nuss procedure has proven unsuccessful.

[52] In 1987, Donald Nuss, based at Children's Hospital of The King's Daughters in Norfolk, Virginia, performed the first minimally invasive repair of pectus excavatum (MIRPE) [53] and presented it much later at a conference in 1997.

Although initially designed to be performed in younger children of less than 10 years of age, whose sternum and cartilage is more flexible, there are successful series of Nuss treatment in patients well into their teens and twenties.

The lower tip of the sternum is then grabbed with a towel-clip and, using blunt dissection, is freed of tissue connections with the pericardium and the pleura.

Then, a stainless steel implant is placed underneath the skin on top of the sternum and ribs, centered over the double screw.

Like the Nuss procedure, Pectus up technique requires follow-up surgery several years later to remove the implanted hardware once the sternum has permanently assumed its new position.

The implant and related hardware used in taulinoplasty is a proprietary product of Ventura Medical Technologies and is marketed as a surgical kit under the brand name Pectus UP.

[60] Pectus up technique was developed to be an alternative to the Nuss procedure that eliminates the risks and drawbacks of entering the thorax.

[61] This procedure does not, however, claim to correct existing cardiac and respiratory problems which, in very rare cases, can be triggered by the pectus excavatum condition.

[67][68] American Olympic swimmer Cody Miller (born 1992) opted not to have treatment for pectus excavatum, even though it limited his lung capacity.

[69][70][71] Actor Joel Kinnaman underwent surgery prior to the filming of Altered Carbon, inserting two metal bars to push the sternum outward in order to correct the deformity.

[75][76] Additionally, Eric Harris, an American mass murderer who perpetrated the Columbine High School massacre, had pectus excavatum.

[78] Some procedures used to treat the condition in animals have not been used in human treatments, such as the use of a cast with sutures wrapped around the sternum and the use of internal and external splints.