Fatal Bronchovascular Fistula after a Single Lung Transplantation: A Case Report

Samano, Marcos Naoyuki; Saka, Juliana Akemi; Caramori, Marlova Luzzi; Pêgo-Fernandes, Paulo Manuel; Jatene, Fábio Biscegli

doi:10.1590/s1807-59322009001000015

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…A sentinel bleed may precede the development of massive hemoptysis. Management options are limited to endovascular stenting, fistula repair and transplant pneumonectomy (47)(48)(49).…”

Section: Fistula Formation Is An Uncommon Complication In the Lungmentioning

confidence: 99%

Lung transplant anastomotic airway complications and bronchoscopic management

Felice¹,

Sethi²

2022

Curr Chall Thorac Surg

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Airway complications after lung transplantation have significantly reduced in incidence over the past several decades, yet remain a persistent source of morbidity and mortality in this patient population.Complications are most commonly seen at the surgical anastomosis and include regional ischemic necrosis, dehiscence, hypertrophic granulation tissue, fistula, tracheobronchomalacia and bronchial stenosis. The mechanism for developing airway complications is incompletely understood, but may be related to airway ischemia, inflammation or infection that contribute to poor anastomotic and wound healing. Risk factors have been linked to donor and recipient characteristics, perioperative conditions, and immunosuppressive regimens. Flexible bronchoscopy remains the gold standard modality for diagnosis, with airway complications arising in the early and late posttransplant period. The management approach is multifaceted and individualized for each airway complication. Bronchoscopic techniques include balloon or rigid dilation, ablative modalities such as cryotherapy and electrocautery, and in advanced cases, airway stenting. Like other benign airway pathologies, silicone stents are generally preferred to self-expanding metallic stents. Surgery is usually reserved for cases that fail to improve with more conservative measures. Herein, we provide a comprehensive review of the risk factors, clinical manifestations, diagnostic classifications, and management strategies of lung transplant airway complications.

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“…A sentinel bleed may precede the development of massive hemoptysis. Management options are limited to endovascular stenting, fistula repair and transplant pneumonectomy (47)(48)(49).…”

Section: Fistula Formation Is An Uncommon Complication In the Lungmentioning

confidence: 99%

Lung transplant anastomotic airway complications and bronchoscopic management

Felice¹,

Sethi²

2022

Curr Chall Thorac Surg

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“…Bronchovascular fistulae are often life-threatening, and massive hemoptysis may be the presenting symptom. Endovascular stenting and surgical treatment with pneumonectomy or fistula resection and reconstruction have been described, although these carry extremely high morbidity (76)(77)(78).…”

Section: Fistulamentioning

confidence: 99%

Management of airway complications following lung transplantation

Frye¹,

Phillips²

2020

Shanghai Chest

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Airway complications (ACs) following lung transplantation are a significant source of morbidity and mortality. The incidence of ACs has decreased over the years with advances in surgical technique.Airway ischemia is thought to be a main risk factor for formation of ACs, although other risk factors are being studied. There is not yet a universally accepted system for grading ACs. These complications include bronchial stenosis, airway necrosis or dehiscence, fistula formation, anastomotic infection, granulation tissue formation, and tracheobronchomalacia. The management of ACs requires a multimodal approach.Bronchoscopic management options include balloon bronchoplasty, cryotherapy, and stent placement.Medical management including antibiotics, mucus clearance techniques and positive pressure ventilation also play a role; surgical management is considered in select cases. This article reviews the risk factors associated with the development of ACs, the clinical presentation and classification of ACs, and current management paradigms.

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Fatal bronchovascular fistula after lobectomy visualized through postmortem computed tomography angiography: A case report

Hinderberger

Fliss

Thali

et al. 2017

Forensic Sci Med Pathol

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False aneurysm of the pulmonary artery complicated by bronchovascular fistula formation represents a rare life threating condition. We report a case of fatal hemoptysis after formation of a bronchial fistula in the late postoperative period after sleeve lobectomy. Cause of death was determined by external postmortem examination, post mortem computed tomography (PMCT) and angiography (PMCTA) without conventional autopsy.

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Fatal Bronchovascular Fistula after a Single Lung Transplantation: A Case Report

Cited by 5 publications

References 17 publications

Lung transplant anastomotic airway complications and bronchoscopic management

Lung transplant anastomotic airway complications and bronchoscopic management

Management of airway complications following lung transplantation

Fatal bronchovascular fistula after lobectomy visualized through postmortem computed tomography angiography: A case report

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