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Ann Thorac Surg 2009;88:e25-e26. doi:10.1016/j.athoracsur.2009.06.069
© 2009 The Society of Thoracic Surgeons
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Fabio B. Jatene
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Right arrow Trachea and bronchi

Case Reports

Endobronchial Closure of Total Bronchopleural Fistula With Occlutech Figulla ASD N Device

Miguel L. Tedde, MD, PhDa,*, Paulo R. Scordamaglio, MDb, Helio Minamoto, MD, PhDa, Viviane R. Figueiredo, MD, PhDb, Carlos C. Pedra, MD, PhDc, Fabio B. Jatene, MD, PhDa

a Thoracic Surgery Department, Heart Institute (InCor) and Hospital das Clinicas of São Paulo Medical School, São Paulo, Brazil
b Respiratory Endoscopy Service, Hospital das Clinicas of São Paulo Medical School, São Paulo, Brazil
c Catheterization Laboratory for Congenital Heart Diseases, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil

Accepted for publication June 9, 2009.

* Address correspondence to Dr Tedde, Thoracic Surgery Department, Hospital das Clinicas of Sao Paulo Medical School, Rua Itambé, 367, apto 151 A, CEP, Higienópolis, São Paulo, 01239-001, Brazil (Email: tedde{at}usp.br).

Bronchopleural fistula may be treated by medical, endoscopic, and surgical techniques, but large fistulas remain a challenge to be closed using endoscopic techniques. We describe the endoscopic closure of a bronchial total fistula with the Occlutech Figulla ASD N device (International Occlutech AB, Helsingborg, Sweden), originally designed for closure of an atrial septal defect. The procedure was conducted without general anesthesia or rigid bronchoscopy, bronchography, or radioscopy. An immediate reduction in the air leak was observed and also later on bronchoscopy, as the device was almost covered by granulation tissue. The endobronchial technique described seems to be safe and effective to manage large bronchopleural fistulas.




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