What steps do I need to take to have my child evaluated for the Nuss Procedure?

Please review the steps on our Nuss Procedure Patient Evaluation Guidelines page.

How long does it take to complete testing?

Depending upon the availability of appointments, it can take one to two months for all of the preliminary testing to be completed.

What is the best way to send the test results to you?

It is best to collect all of your child's test results and mail them to us yourself. Make sure the package is certified so that it can be tracked if lost. Your information will take longer to be received and reviewed if sent to us separately by individual doctors and facilities. Please address all forms and testing to:

Children's Hospital of The King's Daughters
Pediatric Surgery - Nuss Center
601 Children's Lane
Norfolk, VA 23507

Does my child need to see a cardiologist for the heart test, or can my child's pediatrician do the testing?

Since most pediatric offices do not have the specialized equipment, your child may need to see a cardiologist for interpretation. We do not need the echocardiogram video send to us, only the written interpretation.

After I forward all of my child's test results and paperwork, how long will it take to get the results back?

Once we receive all of the required test results and forms, a pectus coordinator will typically contact you within about a week. Please note, the doctor will not review your child's information until all of the information has arrived.

Can I bring my child to your hospital for an evaluation without having any testing done? 

Yes, your child can come for an evaluation without first having any preliminary tests. Keep in mind that if we have the studies to review ahead of time it may save your family from having to make an extra trip. All of the studies are required to determine the severity of you child's pectus deformity and if they are a good candidate for the surgery.

If you do not live in the area, it is beneficial to have the preliminary testing done prior to your arrival. Families that reside outside of the local area generally complete all required tests before their first visit to allow for a complete evaluation. This eliminates the need for a repeat visit before surgery.

Do you ever perform pectus corrective surgery on children younger than 6 years old? 

We generally do not operate on children under six years of age, although there are some exceptions. Therefore, it is not necessary to have all the preliminary testing done until it is time to have surgery. We will consider children under six only if it is determined that the pectus deformity is severe and that the child is developmentally mature enough to follow the postoperative restrictions on physical activity.

Many younger children feel good within one week of returning home, but they are unable to engage in rough physical activity for six weeks. This can be difficult to manage in an active, younger child who does not understand the consequences of not complying with postoperative instructions.

Is my 19-year-old too old to have corrective surgery for pectus?

No, your child is not too old to have corrective surgery for pectus. For adults over the age of 25, prior administrative approval is required before surgery can be scheduled.

Is pectus correction ever an emergency?

No. If you child's symptoms are worsening, then you should begin the steps to have them evaluated and plan for surgery immediately, but correcting the chest is never an emergency. This is a procedure that must be planned. Take your time, and prepare your family and your child for the procedure and recovery.

Will my child be able to participate in sports after the Nuss procedure?

 We encourage our patients to maintain active and healthy lifestyles before and after surgery. Three months after surgery, patients can return to competitive sports; however, contact sports such as football, boxing, and wrestling are discouraged.

If I decide to bring my child to have corrective surgery at CHKD, how long will I need to plan on staying in town?

You should plan on staying here for at least 10 days. A typical schedule is as follows:

  • Day 1: Evaluation, tour of the hospital, labs.
  • Day 2: Visit with the anesthesia team.
  • Day 3: Surgery.
  • Day 4-8: Hospital stay.

Learn more about travel and lodging while your child is in the hospital.

Can my child take a long car or plane ride home after the procedure?

Both driving and flying should be fine after your child is released from the hospital. If you have a long drive, try to schedule an overnight stay to break up the trip. If you are traveling by plane, arrange for wheel chair service at the airport and at each layover stop, should the need arise. Requesting bulkhead seats will also provide a bit more leg room and make your child more comfortable during the plane ride.

What do I need to do for the follow-up?

If you live out of state, you need to schedule a postoperative visit with your child's pediatrician or primary care physician within two to four weeks of returning home. We will contact your child's healthcare provider and provide a comprehensive report of the procedure along with guidance on what to look for at this visit.

If you live locally, you will return to CHKD for your postoperative check up.

The next planned visits to CHKD are at six months, one year, and at the two- or three-year anniversary to have the bar removed.