title: Endoscopic treatment of tracheobronchial tree fistulas using atrial septal defect occluders: preliminary results.
abstract: Fistulas in the tracheobronchial tree (bronchopleural and tracheoesophageal fistulas) have a multifactorial etiology and present a variable incidence in the literature. In general, the related morbidity and mortality are high. Once such a fistula has been diagnosed, surgical closure is formally indicated. However, the clinical status of affected patients is usually unfavorable, which precludes the use of additional, extensive surgical interventions. In addition, attempts at endoscopic closure of these fistulas have seldom been successful, especially when the fistula is large in diameter. We report the cases of three patients submitted to endoscopic closure of fistulas, two of which were larger than 10 mm in diameter, by means of the insertion of atrial septal defect occluders. The procedure was minimally invasive, and the initial results were positive. The results indicate that this is a promising technique for the resolution of tracheobronchial tree fistulas.
authors.affiliation: Department of Bronchoscopy, University of São Paulo School of Medicine Hospital das Clínicas Heart Institute, São Paulo, Brazil. paulo.scorda@click21.com.br
authors.forename: Paulo Rogério
authors.initials: PR
authors.lastname: Scordamaglio
authors.forename: Miguel Lia
authors.initials: ML
authors.lastname: Tedde
authors.forename: Hélio
authors.initials: H
authors.lastname: Minamoto
authors.forename: Carlos Augusto Cardoso
authors.initials: CA
authors.lastname: Pedra
authors.forename: Fábio Biscegli
authors.initials: FB
authors.lastname: Jatene
mesh_terms: D000368:Aged; D001983:Bronchial Fistula / Q000628:therapy*; D001999:Bronchoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016156:Respiratory Tract Fistula / Q000628:therapy*; D055989:Septal Occluder Device; D014133:Tracheal Diseases / Q000628:therapy*