Bronchovascular Fistula Formation: A Rare Airway Complication After Lung Transplantation

Airway Complications After Lung Transplantation

“…1,76,106 In addition to hemoptysis, air embolism and sepsis have been described. 100,107 Its management literature is limited to case reports of pneumonectomy and bilobectomy.…”

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

“…The appearance of bronchovascular fistulas after lung transplantation has been previously reported, but mainly in association with the pulmonary artery 3,5,7. Knight et al4 reported three cases of fatal bronchial fistulas occurring at the azygos vein and the descending aorta.…”

“…Fistulas between vascular structures and the tracheobronchial tree are a potentially fatal condition associated with hemoptysis 3,4,5. The majority of these types of complications are related to general thoracic surgical procedures, especially aneurysms of the thoracic aorta 6.…”

“…Previous bronchoscopy revealed the presence of necrotic and granulated tissue around the site of anastomosis, but bronchoscopy was not able to identify the formation of a fistula. Fungal infection, or aspergillosis, is frequently associated with bronchial complications, such as stenosis, dehiscence and bronchovascular fistulas 4,5,7,19. This infection increases the risk of morbimortality after lung transplantation, which varies according to the time of onset, the site of infection and the type of transplant procedure 20…”

Bronchomediastinal Fistula Caused by Endobronchial Aspergilloma

“…In lung transplant recipients, Aspergillus is reported to erode from the airway into the mediastinum (1), esophagus (11), or vasculature (12)(13)(14), especially from the anastomosis site. The anastomosis represents an area of significant mucosal disruption, which combined with ischemia from the sutures and loss of bronchial circulation as well as immunosuppressive agents presents an optimal environment for Aspergillus to erode into the surrounding structures (3).…”