Bilateral Lung Transplantation and Simultaneous Pectus Excavatum Correction Using the Nuss Technique

Area of Science:

• Cardiothoracic Surgery
• Pulmonary Medicine
• Medical Engineering

Background:

• Severe chest wall deformities, such as pectus excavatum, are typically contraindications for lung transplantation.
• Idiopathic pulmonary fibrosis (IPF) necessitates lung transplantation for end-stage disease.

Purpose of the Study:

• To evaluate the feasibility and functional outcomes of combined lung transplantation and pectus excavatum correction.
• To present a case study of a patient with IPF and severe pectus excavatum undergoing simultaneous surgical procedures.

Main Methods:

• A 38-year-old male patient with IPF and a Haller index of 4.3 underwent bilateral sequential lung transplantation.
• Simultaneous pectus excavatum correction was performed using anterolateral thoracotomies and Nuss bar insertion.
• Peripheral femorofemoral venoarterial extracorporeal membrane oxygenation (ECMO) provided circulatory support during the procedures.

Main Results:

• The patient successfully underwent bilateral sequential lung transplantation and pectus excavatum repair.
• Postoperative total lung capacity increased significantly from 4.1 L to 5.8 L.
• The combined approach demonstrated a good functional outcome for the patient.

Conclusions:

• Lung transplantation in conjunction with pectus excavatum correction is a feasible surgical option.
• This combined approach can lead to improved pulmonary function and positive outcomes in selected patients.
• The use of ECMO is critical for supporting patients undergoing complex combined thoracic surgeries.