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

https://doi.org/10.1016/j.athoracsur.2009.06.069Get rights and content

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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Comment

Several methods of endoscopic treatment have been tried for the closure of BPFs with limited success and large BPFs have a high failure rate when treated endoscopically.

A recent article [7] described a technique for the endobronchial closure of BPF by the implantation of an atrial septal defects occluder. The Occlutech Figulla is an atrial septal ocluder with encouraging clinical experience in the heart [8].

Although we applied a similar technique as described by Kramer and colleagues [7], some

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