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Endobronchial Closure of Bronchopleural Fistulae Using Amplatzer Devices: Our Experience and Literature Review

Oren Fruchter, MD; Mordechai R. Kramer, MD; Tamir Dagan, MD; Yael Raviv, MD; Nader Abdel-Rahman, MD; Milton Saute, MD; Elchanan Bruckheimer, MBBS
Author and Funding Information

From the Pulmonary Institute (Drs Fruchter, Kramer, Raviv, and Abdel-Rahman) and the Department of Cardiothoracic Surgery (Dr Saute), Rabin Medical Center, Petah Tiqwa; the Department of Pediatric Cardiology (Drs Dagan and Bruckheimer), Schneider Children’s Medical Center of Israel, Petah Tiqwa; and the Sackler School of Medicine (Drs Dagan and Bruckheimer), Tel Aviv University, Tel Aviv, Israel.

Correspondence to: Mordechai R. Kramer, MD, the Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel 49100; e-mail: kremerm@clalit.org.il


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(3):682-687. doi:10.1378/chest.10-1528
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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.

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