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Endoscopic Occlusion of Tracheoesophageal Fistula in Ventilated Patients Using an Amplatzer Septal Occluder

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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.

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Abbreviations

TEF:

Tracheoesophageal fistula

References

  1. Mooty RC, Rath P, Self M et al (2007) Review of tracheo-esophageal fistula associated with endotracheal intubation. J Surg Educ 64:237–240

    Article  PubMed  Google Scholar 

  2. Payne DK, Anderson WM, Romero MD et al (1990) Tracheoesophageal fistula formation in intubated patients: risk factors and treatment with high-frequency jet ventilation. Chest 98:161–164

    Article  CAS  PubMed  Google Scholar 

  3. Kasbeker AV, Sherman IW (2013) Closure of minor tracheoesophageal fistulae with calcium hydroxlapatite. Aurius Nasus Larynx 40:491–492

    Article  Google Scholar 

  4. Sxordamaglio PR, Tedde ML, Minamoto H et al (2009) Endoscopic treatment of tracheobronchial tree fistulas using atrial septal defect occluders: preliminary results. J Bras Pneumol 35:1156–1160

    Article  Google Scholar 

  5. Coppola F et al (2010) Cardiac septal umbrella for closure of a tracheoesophageal fistula. Endoscopy 42:E318–E319

    Article  PubMed  Google Scholar 

  6. Repici A, Presbitero P, Carlino A et al (2010) First human case of esophagus-tracheal fistula closure by using a cardiac septal occluder. Gastrointest Endosc 71:867–869

    Article  PubMed  Google Scholar 

  7. Green DA, Moskowitz WB, Shepherd RW (2010) Closure of a broncho-to-neoesophageal fistula using an Amplatzer Septal Occluder device. Ann Thorac Surg 89:2010–2012

    Article  PubMed  Google Scholar 

  8. Boudoulas KD, Elinoff J, Resae JR (2010) Bronchopulmonary fistula closure with an Amplatzer Multi-Fenestrated Septal Occluder. Catheter Cardiovasc Interv 75:455–458

    PubMed  Google Scholar 

  9. Kramer MR, Peled N, Shitrit D et al (2008) Use of Amplatzer device for endobronchial closure of bronchopleural fistulas. Chest 133:1481–1484

    Article  PubMed  Google Scholar 

  10. Tedde ML, Scordamaglio PR, Minamoto H, Figueiredo VR, Pedra CC, Jatene FB (2009) Endobronchial closure of total bronchopleural fistula with Occlutech Figulla ASD N device. Ann Thorac Surg 88:e25–e26

    Article  PubMed  Google Scholar 

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Acknowledgments

The assistance and cooperation of Dr Sherman, Dr Zuckerman and Dr Rosen (Departments of Anesthesiology, Chest Surgery and Surgery A) is gratefully acknowledged. The excellent assistance of the Operating Room nurses enabled the efficient and safe implementation of the procedures.

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Correspondence to Smadar Cohen-Atsmoni.

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Cohen-Atsmoni, S., Tamir, A., Avni, Y. et al. Endoscopic Occlusion of Tracheoesophageal Fistula in Ventilated Patients Using an Amplatzer Septal Occluder. Indian J Otolaryngol Head Neck Surg 67, 196–199 (2015). https://doi.org/10.1007/s12070-015-0842-7

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  • DOI: https://doi.org/10.1007/s12070-015-0842-7

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