ArticleJournal of cardiothoracic surgery2025
Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula.
Article in Journal of cardiothoracic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPost-pneumonectomy bronchopleural fistula (BPF) is a life-threatening event whose treatment is not standardized. CASE PRESENTATION: We report the management of a 28-year-old patient with a 3-year history of BPF complicating right pneumonectomy for congenital emphysema. Despite closure by an Amplatzer device, the patient had chronic pyothorax and severely deteriorated general health and quality of life. An attempt at Amplatzer device removal through an open window thoracostomy failed. A median sternotomy was performed, the carina was resected, and the left main bronchus was anastomosed to the trachea. The thoracostomy was closed using fasciocutaneous pedicled flaps. At 9 months, the patient was doing well.
conclusionThe utilisation of an Amplatzer device to close a broncho-pleural fistula can have adverse effects and potentially result in fatal sepsis in those cases where it is unsuccessful. The endoscopic treatment of BPF should be reserved for expert centers, considering the location, size, and stability of the fistula when choosing the treatment strategy. The surgical management of failed Amplatzer closure may be extremely complex, requiring a highly experienced team.
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