Closure of Nonmalignant Tracheoesophageal Fistula Using an Atrial Septal Defect Occluder: Case Report and Review of the Literature

Jiang, Ping; Yu, Dong; Jie, Bing; Jiang, Sen

doi:10.1007/s00270-015-1147-7

Cited by 10 publications

(8 citation statements)

References 12 publications

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“…CSOs are shape-memory, self-expanding double-disc closure devices composed of nitinol and interwoven polyester 2. Although data is limited regarding the use of CSOs, these properties make it useful in treating fistulas that are difficult to manage using traditional endoscopic techniques 5. The nitinol structure with interwoven polyester liner is thought to facilitate tissue in-growth while sealing the fistula tract.…”

Section: Discussionmentioning

confidence: 99%

Closure of recurrent colovaginal fistulas using AMPLATZER occluder device

Simmons

Ahmed

Mader

et al. 2022

BMJ Open Gastroenterol

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A 79-year-old woman and a 92-year-old woman were referred to the gastroenterology department for management of persistent colovaginal fistula despite surgical and non-surgical management. Both patients had several hospitalisations for recurrent urinary tract infections. After failed surgical management and endoscopy using over-the-scope clipping, both patients underwent endoscopic closure using the Amplatzer cardiac septal occluder device. Both patients underwent successful closure and had no recurrence of symptoms at 6-month follow-up. Although there are several therapies available for persistent colovaginal fistulas, most involve multiple sessions and have high recurrence rate. There have been reports in the literature of cardiac septal occluders being used in the management of upper gastrointestinal tract fistulas, but few cases exist explaining their role in the management of colovaginal fistulas. Our cases demonstrate that cardiac septal occluders may be a viable option for management of fistulas and warrants further studies to reproduce its effectiveness and safety.

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Section: Discussionmentioning

confidence: 99%

Closure of recurrent colovaginal fistulas using AMPLATZER occluder device

Simmons

Ahmed

Mader

et al. 2022

BMJ Open Gastroenterol

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“…The use of Amplatzer occluders, initially designed for cardial septal defect occlusion, in the treatment of non-malignant refractory ERF has been reported in 10 case reports (11 patients) since 2006 5 6 10 11 12 13 14 15 16 17 . In four of 11 cases, the ERF occurred after esophagectomy, and in four of 11 patients after prolonged mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

Amplatzer occluders for refractory esophago-respiratory fistulas: a case series

et al. 2021

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Background and study aims Endoscopic management of esophagorespiratory fistulas (ERF) is challenging and currently available options (stents, double pigtail, endoscopic vacuum therapy) are not very effective. We report the feasibility and efficacy of endoscopic placement of Amplatzer cardiovascular occluders for this indication. Patients and methods This was a single-center, prospective study (June 2019 to September 2020) of all patients with non-malignant ERF persistent after conventional management with esophageal and/or tracheal stents. The primary outcome was the technical feasibility of Amplatzer placement. Secondary outcomes were clinical success defined by effective ERF occlusion and resolution of respiratory symptoms allowing oral food intake. Results Endoscopic placement of Amplatzer occluders was feasible in 83 % of patients (5/6), with a 50 % (3/6) clinical success rate at 9 months. The mortality rate was 33 % (2/6). Conclusions An Amplatzer cardiac or vascular occluder is a feasible and safe treatment option for refractory ERF, with a 50 % short-term clinical success.

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“…The Amplatzer TM cardiac septal occluder, a double-disc shaped device made of nitinol and polyester, has been used to successfully occlude benign ADFs ( 44 - 46 ). These devices can be removed once the esophageal side has re-epithelialized but will partially occlude the airway lumen while in place and may not be suitable for patients with existing airway obstruction ( 47 ). Cases of device migration into the airway as well as fistula enlargement have been reported ( 47 , 48 ).…”

Section: Other Bronchoscopic Interventionsmentioning

confidence: 99%

“…These devices can be removed once the esophageal side has re-epithelialized but will partially occlude the airway lumen while in place and may not be suitable for patients with existing airway obstruction ( 47 ). Cases of device migration into the airway as well as fistula enlargement have been reported ( 47 , 48 ). Chemical cautery, argon plasma coagulation, and lasers have been used to seal small fistulas ( 35 ).…”

Section: Other Bronchoscopic Interventionsmentioning

confidence: 99%

Management of aero-digestive fistulas in adults: the bronchoscopist’s perspective

Chang,

Lin

2023

Mediastinum

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Aero-digestive fistulas (ADFs) are pathologic connections between the airways and gastrointestinal system. These most commonly occur between the central airways and esophagus. Fistulas may develop congenitally or be acquired from a benign or malignant process. Most fistulas presenting in adulthood are acquired, with similar rates of benign and malignant etiologies. Symptoms may severely impact a patient’s quality of life and result in dyspnea, cough, and oral intolerance. ADFs have been associated with increased mortality, often related to pneumonias and malnutrition. Management is multifaceted and includes a multidisciplinary approach between the pulmonologist, gastroenterologist, and thoracic surgeon. While definitive management can be achieved with surgery, this is typically reserved for benign causes as surgical repair is often impractical in patients with advanced malignancies. With malignant causes, less invasive endoscopic and/or bronchoscopic interventions may be indicated. Stenting is the most common non-surgical invasive intervention performed. Stents can be placed in the esophagus, airway, or both. There is limited data that suggests outcomes may be better when esophageal stenting is performed with or without airway stenting. Airway stents are indicated when there is airway compromise, inadequate sealing of the fistula with an esophageal stent alone, or when an esophageal stent cannot be placed. This review will provide an overview of approaching ADFs from the bronchoscopist’s perspective.

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Closure of Nonmalignant Tracheoesophageal Fistula Using an Atrial Septal Defect Occluder: Case Report and Review of the Literature

Cited by 10 publications

References 12 publications

Closure of recurrent colovaginal fistulas using AMPLATZER occluder device

Closure of recurrent colovaginal fistulas using AMPLATZER occluder device

Amplatzer occluders for refractory esophago-respiratory fistulas: a case series

Management of aero-digestive fistulas in adults: the bronchoscopist’s perspective

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