TY - JOUR
T1 - Endobronchial closure of bronchopleural fistulae using amplatzer devices
T2 - Our experience and literature review
AU - Fruchter, Oren
AU - Kramer, Mordechai R.
AU - Dagan, Tamir
AU - Raviv, Yael
AU - Abdel-Rahman, Nader
AU - Saute, Milton
AU - Bruckheimer, Elchanan
PY - 2011/3/1
Y1 - 2011/3/1
N2 - Bronchopulmonary fistulae (BPFs) are a severe complication of lobectomy and pneumonectomy and are associated with high rates of morbidity and mortality. We have developed a novel, minimally invasive method of central BPF closure using Amplatzer devices (ADs) that were originally designed for the transcatheter closure of cardiac defects. Ten patients with 11 BPFs (eight men and two women, aged 66.3 ± 10.1 years [mean ± SD]) were treated under conscious sedation with bronchoscopic closure of the BPFs using ADs. A nitinol double-disk occluder device was delivered under direct bronchoscopic guidance over a guidewire into the fistula. By extruding a disk on either side of the BPF, the fistula was occluded. Bronchography was performed by injecting contrast medium through the delivery sheath following the procedure to ensure correct device positioning. In nine patients, the procedure was successful and symptoms related to the BPF disappeared following closure by the AD. The results were maintained over a median follow-up period of 9 months. Therefore, we state that endobronchial closure using an AD is a safe and effective method for treatment of a postoperative BPF.
AB - Bronchopulmonary fistulae (BPFs) are a severe complication of lobectomy and pneumonectomy and are associated with high rates of morbidity and mortality. We have developed a novel, minimally invasive method of central BPF closure using Amplatzer devices (ADs) that were originally designed for the transcatheter closure of cardiac defects. Ten patients with 11 BPFs (eight men and two women, aged 66.3 ± 10.1 years [mean ± SD]) were treated under conscious sedation with bronchoscopic closure of the BPFs using ADs. A nitinol double-disk occluder device was delivered under direct bronchoscopic guidance over a guidewire into the fistula. By extruding a disk on either side of the BPF, the fistula was occluded. Bronchography was performed by injecting contrast medium through the delivery sheath following the procedure to ensure correct device positioning. In nine patients, the procedure was successful and symptoms related to the BPF disappeared following closure by the AD. The results were maintained over a median follow-up period of 9 months. Therefore, we state that endobronchial closure using an AD is a safe and effective method for treatment of a postoperative BPF.
UR - http://www.scopus.com/inward/record.url?scp=79952212884&partnerID=8YFLogxK
U2 - 10.1378/chest.10-1528
DO - 10.1378/chest.10-1528
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AN - SCOPUS:79952212884
VL - 139
SP - 682
EP - 687
JO - Chest
JF - Chest
SN - 0012-3692
IS - 3
ER -