title: Endobronchial closure of bronchopleural fistulae using amplatzer devices: our experience and literature review.
abstract: 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.
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Petah Tiqwa.
authors.forename: Oren
authors.initials: O
authors.lastname: Fruchter
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Petah Tiqwa. Electronic address: kremerm@clalit.org.il.
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
authors.affiliation: Department of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tiqwa; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Tamir
authors.initials: T
authors.lastname: Dagan
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Petah Tiqwa.
authors.forename: Yael
authors.initials: Y
authors.lastname: Raviv
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Petah Tiqwa.
authors.forename: Nader
authors.initials: N
authors.lastname: Abdel-Rahman
authors.affiliation: Department of Cardiothoracic Surgery, Rabin Medical Center, Petah Tiqwa.
authors.forename: Milton
authors.initials: M
authors.lastname: Saute
authors.affiliation: Department of Pediatric Cardiology, Schneider Children's Medical Center of Israel, Petah Tiqwa; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Elchanan
authors.initials: E
authors.lastname: Bruckheimer
mesh_terms: D000368:Aged; D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery*; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D011013:Pneumonectomy / Q000009:adverse effects; D013510:Pulmonary Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D055989:Septal Occluder Device; D016896:Treatment Outcome