title: Endoscopic Occlusion of Tracheoesophageal Fistula in Ventilated Patients Using an Amplatzer Septal Occluder.
abstract: Acquired tracheoesophageal fistula (TEF) is a challenging, life threatening condition. It most commonly appears in critically ill patients requiring prolonged mechanical ventilation, who cannot withstand open neck or chest surgery. An endoscopic technique could be better tolerated by these patients. We present our experience using a cardiac Amplatzer ASD septal occluder for an endoscopic TEF repair in ventilation-dependent patients. Two high risk patients underwent the procedure under general anesthesia and close respiratory monitoring. In one patient the device was inserted through the trachea and in the other through the esophagus. In both cases fistula closure was achieved for different periods of time allowing the patients a temporary relief of symptoms. The procedure was well tolerated by the patients, and no significant adverse effect documented. The technique was successful as a temporary solution for unstable patients with TEFs and should be considered as a treatment modality for similar patients.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, The Edith Wolfson Medical Center, Tel-Aviv University Sackler School of Medicine, P.O. Box 5, 58100 Holon, Israel.
authors.forename: Smadar
authors.initials: S
authors.lastname: Cohen-Atsmoni
authors.affiliation: Department of Pediatric Cardiology, The Edith Wolfson Medical Center, Tel-Aviv University Sackler School of Medicine, Holon, Israel.
authors.forename: Akiva
authors.initials: A
authors.lastname: Tamir
authors.affiliation: Department of Gastroenterology, The Edith Wolfson Medical Center, Tel-Aviv University Sackler School of Medicine, Holon, Israel.
authors.forename: Yona
authors.initials: Y
authors.lastname: Avni
authors.affiliation: Department of Pulmonary Medicine, The Edith Wolfson Medical Center, Tel-Aviv University Sackler School of Medicine, Holon, Israel.
authors.forename: Israel E
authors.initials: IE
authors.lastname: Priel
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, The Edith Wolfson Medical Center, Tel-Aviv University Sackler School of Medicine, P.O. Box 5, 58100 Holon, Israel.
authors.forename: Yehudah
authors.initials: Y
authors.lastname: Roth
keywords: Amplatzer septal occluder; Mechanical ventilation; Tracheoesophageal fistula