Multistage Approach to Lung Transplantation in a Cystic Fibrosis Patient with Chronic Superior Vena Cava Occlusion and Patent Foramen Ovale

Superior vena cava (SVC) stenosis or obstruction occurs in approximately 9% of cystic fibrosis patients. Percutaneous recanalization can be successful in most cases of SVC stenosis but can be extremely difficult when complete occlusion is present. As a result, patients with SVC occlusion may be denied lung transplantation. We describe an innovative, staged approach where we performed successful bilateral lung transplantation in a patient with SVC occlusion and patent foramen ovale after SVC bypass with an aortic homograft.