Simultaneous pectus excavatum correction and lung transplantation-A case series

Area of Science:

• Thoracic Surgery
• Transplantation Medicine
• Cardiopulmonary Surgery

Background:

• Severe chest wall deformities, such as pectus excavatum, have historically been absolute contraindications for lung transplantation.
• The impaired chest compliance associated with these deformities raises concerns for high risks of postoperative respiratory complications, morbidity, and mortality.

Observation:

• This study reports on 3 patients with severe chest wall deformities who underwent bilateral lung transplantation and simultaneous deformity correction.
• Procedures included Nuss or modified Ravitch for pectus excavatum correction, alongside size-reduced double lung transplants.

Findings:

• Two patients were children, and one had severe asymmetric pectus.
• While 2 patients required prolonged weaning and tracheostomy, all 3 are alive and in excellent condition at 72, 60, and 12 months post-transplant.

Implications:

• This case series suggests that severe chest wall deformities should not be an absolute contraindication for lung transplantation.
• A combined surgical approach for lung transplantation and chest wall deformity correction is feasible in selected patients, offering good long-term results.