If the level of the patient’s deformity is too severe (check Haller Index), and can not be fixed with pectus excavatum exercises, then surgical repair is the only choice. In order to have the Nuss procedure a series of tests must be executed to get the necessary information needed for successful surgery.
- Preoperative computer tomography (CT) scan – The CT scan is used for viewing bone injuries/deformities, lung or chest problems. In this case, it is used to accurately determine the severity of the pectus excavatum deformity. If you want the insurance to cover costs for the operation, they will require a CT scan.
- Pulmonary function tests (PFTs) – These are tests to diagnose your breathing patterns and to measure how well your lungs are working. Decreased lung capacity is a very usual side effect of patients with pectus excavatum and these tests determine the exact percentage of your lungs capacity and how well they distribute the oxygen to the rest of your body. This is also needed in case the patient is trying to get insurance approval.
- Electrocardiogram (EKG) – EKG is a test used to check if there are any problems with the electrical activity of our heart. This is needed because as we mentioned earlier, some severe cases of pectus excavatum can put the heart under pressure, or even slightly displace it.
- Metal allergy test – although this is very rare among patients (less than 1%), it is a must have before undergoing the Nuss procedure. The test determines if the patient has suspended metal allergy or the level of hypersensitivity to metals. If the test is positive than a titanium nuss bar is used instead of a metal bar.