title: Endobronchial closure of bronchopleural fistula using Amplatzer device.
abstract: BACKGROUND
  Bronchopleural fistulas (BPF) are a dreaded complication after lobectomy and pneumonectomy and are associated with high morbidity and mortality. BPF are treated by a range of surgical and endoscopic techniques. Amplatzer devices (ADs), normally used for the closure of cardiac defects, may enable the minimally invasive occlusion of these defects.
  
  
  METHODS
  Three patients with BPF were treated with the bronchoscopic closure of BPF using AD. Under general anaesthesia, the fistula was located using bronchography and the self-expanding AD was placed under direct bronchoscopic and fluoroscopic guidance into the fistula. Bronchography was used to control the complete occlusion of the BPF.
  
  
  RESULTS
  Three male patients with a mean age of 63 years (range, 53-73 years) were successfully treated by AD. Two BPF occurred after lobectomy of the right lower lobe for lung cancer and one after right pneumonectomy for lung cancer. In all patients the bronchoscopic procedure was successful and symptoms of empyema and BPF showed no recurrence over a median follow-up of 22 months.
  
  
  CONCLUSIONS
  Endobronchial closure of BPF using AD represents a safe, effective and promising method for postoperative BPF.
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Pneumology, Center for Thoracic Surgery Munich, (Asklepios Medical Center Munich-Gauting/Ludwig-Maximilians-University Munich), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Laura V
authors.initials: LV
authors.lastname: Klotz
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Pneumology, Center for Thoracic Surgery Munich, (Asklepios Medical Center Munich-Gauting/Ludwig-Maximilians-University Munich), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gesierich
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Pneumology, Center for Thoracic Surgery Munich, (Asklepios Medical Center Munich-Gauting/Ludwig-Maximilians-University Munich), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schott-Hildebrand
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Pneumology, Center for Thoracic Surgery Munich, (Asklepios Medical Center Munich-Gauting/Ludwig-Maximilians-University Munich), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: Hatz
authors.affiliation: 1 Department of Thoracic Surgery, 2 Department of Pneumology, Center for Thoracic Surgery Munich, (Asklepios Medical Center Munich-Gauting/Ludwig-Maximilians-University Munich), Member of the German Center for Lung Research (DZL), Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Lindner
keywords: Bronchopleural fistula (BPF); bronchoscopy; empyema; lobectomy; pneumonectomy