Severe chest wall deformities are considered a contraindication for lung transplantation. A 38-year-old man with idiopathic pulmonary fibrosis and severe pectus excavatum with a Haller index of 4.3 was considered eligible and listed for lung transplantation. Bilateral sequential transplantation and simultaneous correction of the pectus excavatum were performed via anterolateral thoracotomies and Nuss bar insertion with peripheral femorofemoral venoarterial extracorporeal membrane oxygenation support. Total lung capacity increased from 4.1 L preoperative to 5.8 L postoperative. This case demonstrates that a combined approach is feasible with good functional outcome.
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