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Michael C. Mauney
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Ann Thorac Surg 2000;70:301-302
© 2000 The Society of Thoracic Surgeons

Case report

Intrathoracic fibrin sealant application using computed tomography fluoroscopy

Patrick J. O’Neill, PhD, MDa, Heidi L. Flanagan, BSNc, Michael C. Mauney, MDb, William D. Spotnitz, MDb,c, Thomas M. Daniel, MDb,c

a Department of General Surgery, University of Virginia Health System, Charlottesville, Virginia, USA
b Department of Thoracic and Cardiovascular Surgery, University of Virginia Health System, Charlottesville, Virginia, USA
c Tissue Adhesive Center, University of Virginia Health System, Charlottesville, Virginia, USA

Address reprint requests to Dr Daniel, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia Health System, Box 310, Charlottesville, VA 22908
e-mail: tmd5m{at}virginia.edu

Persistent intrathoracic airspace and bronchopleural fistula remain a problem following lung resection or in patients with severe bullous disease experiencing a spontaneous pneumothorax. Although fibrin sealant has been used successfully to manage such air-leaks, precise nonoperative intrathoracic application is difficult. This report describes a novel technique using computed tomography fluoroscopy for catheter-directed FS application through a previously placed thoracostomy tube. Continuous computed tomography-fluoroscopy images allowed real-time catheter manipulation for precise placement of fibrin sealant.




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