University of Missouri Health Care’s Children’s Hospital offers a comprehensive chest wall deformity program that treats kids and adults.

Our surgeons, Venkatraman Ramachandran, MD, and Ashwin Pimpalwar, MD, are specially trained in minimally invasive procedures and can treat the most complex chest wall deformities. We take a whole-team approach to create a customized treatment plan that provides the best care for your family. When needed, we work together to coordinate your care with specialists and subspecialists from across MU Health Care, including plastic surgeon Arshad Muzaffar, MD, orthopaedic surgeon Daniel Hoernschemeyer, MD, radiologist Dana Mazuru-Witten, MD, cardiothoracic surgeon Sebastian Wiesemann, MD, as well as anesthesiologists, pulmonologists, cardiologists, geneticists, pain specialists and more.

Chest Wall Deformities We Treat

  • Pectus excavatum: Also known as “sunken chest” or “funnel chest,” pectus excavatum occurs when an abnormal growth of cartilage within the chest wall pushes the sternum and ribs inward, creating a caved-in or sunken appearance.
  • Pectus carinatum: Also known as “pigeon chest,” pectus carinatum is when chest cartilage grows up and out, forcing the sternum forward.
  • Poland syndrome: A condition in which the chest wall muscle and ribs are underdeveloped or absent.
  • Slipping ribs: A condition in which lower rib cartilage slips and moves.
  • Congenital rib anomalies: Rib cartilage deformities.
  • Juene syndrome: A condition characterized by a bell-shaped, narrow chest that causes breathing difficulties.
  • Jarcho-Levin syndrome: A condition characterized by a crab-like chest that causes breathing difficulties.

Your Experience

Because of the visual nature of chest wall conditions, many can be diagnosed by a primary care physician, who will then refer your family to our surgery team to discuss treatment options.

Your first appointment at our clinic will be a consultation with an advanced practice nurse and a surgeon. A comprehensive medical, surgical and family history will be taken at this visit, and we will also conduct a physical exam. Then, our team will provide an in-depth description of the diagnosis and offer both surgical and nonsurgical treatment options.

After the initial visit, your surgeon might order a few tests — such as an echocardiogram, CT or MRI scan, or pulmonary function test — to help build the treatment plan and define next steps. An echocardiogram is an ultrasound of the heart that helps us assess if a chest wall deformity is impacting a patient’s heart anatomy and function. CT and MRI scans help us measure the precise severity and depth of pectus excavatum. And pulmonary function testing tells us the strength of our patient’s lung capacity. This specific test occurs in our pulmonary diagnostics lab.