Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula
Abstract Background Post-pneumonectomy bronchopleural fistula (BPF) is a life-threatening event whose treatment is not standardized. Case presentation We report the management of a 28-year-old patient with a 3-year history of BPF complicating right pneumonectomy for congenital emphysema. Despite clo...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03285-7 |
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| author | Yohann Vincent Alessandra Lenzini Amir Hanna Nicolas Leymarie Brendan Le Picault Elie Fadel |
| author_facet | Yohann Vincent Alessandra Lenzini Amir Hanna Nicolas Leymarie Brendan Le Picault Elie Fadel |
| author_sort | Yohann Vincent |
| collection | DOAJ |
| description | Abstract Background Post-pneumonectomy bronchopleural fistula (BPF) is a life-threatening event whose treatment is not standardized. Case presentation We report the management of a 28-year-old patient with a 3-year history of BPF complicating right pneumonectomy for congenital emphysema. Despite closure by an Amplatzer device, the patient had chronic pyothorax and severely deteriorated general health and quality of life. An attempt at Amplatzer device removal through an open window thoracostomy failed. A median sternotomy was performed, the carina was resected, and the left main bronchus was anastomosed to the trachea. The thoracostomy was closed using fasciocutaneous pedicled flaps. At 9 months, the patient was doing well. Conclusion The utilisation of an Amplatzer device to close a broncho-pleural fistula can have adverse effects and potentially result in fatal sepsis in those cases where it is unsuccessful. The endoscopic treatment of BPF should be reserved for expert centers, considering the location, size, and stability of the fistula when choosing the treatment strategy. The surgical management of failed Amplatzer closure may be extremely complex, requiring a highly experienced team. |
| format | Article |
| id | doaj-art-740780f2f5f4470992af71cb754bf0fa |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-740780f2f5f4470992af71cb754bf0fa2025-01-19T12:38:15ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-012011410.1186/s13019-024-03285-7Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistulaYohann Vincent0Alessandra Lenzini1Amir Hanna2Nicolas Leymarie3Brendan Le Picault4Elie Fadel5Department of Thoracic and Vascular Surgery, Sainte Anne Military Teaching HospitalDepartment of Thoracic and Vascular Surgery, and Lung Transplantation, Marie-Lannelongue HospitalPulmonology Department, Marie-Lannelongue HospitalDepartment of Reconstructive Surgery, Gustave RoussyDepartment of Thoracic and Vascular Surgery, and Lung Transplantation, Marie-Lannelongue HospitalDepartment of Thoracic and Vascular Surgery, and Lung Transplantation, Marie-Lannelongue HospitalAbstract Background Post-pneumonectomy bronchopleural fistula (BPF) is a life-threatening event whose treatment is not standardized. Case presentation We report the management of a 28-year-old patient with a 3-year history of BPF complicating right pneumonectomy for congenital emphysema. Despite closure by an Amplatzer device, the patient had chronic pyothorax and severely deteriorated general health and quality of life. An attempt at Amplatzer device removal through an open window thoracostomy failed. A median sternotomy was performed, the carina was resected, and the left main bronchus was anastomosed to the trachea. The thoracostomy was closed using fasciocutaneous pedicled flaps. At 9 months, the patient was doing well. Conclusion The utilisation of an Amplatzer device to close a broncho-pleural fistula can have adverse effects and potentially result in fatal sepsis in those cases where it is unsuccessful. The endoscopic treatment of BPF should be reserved for expert centers, considering the location, size, and stability of the fistula when choosing the treatment strategy. The surgical management of failed Amplatzer closure may be extremely complex, requiring a highly experienced team.https://doi.org/10.1186/s13019-024-03285-7Right bronchial fistulaPneumonectomyCarina surgeryAmplatzer |
| spellingShingle | Yohann Vincent Alessandra Lenzini Amir Hanna Nicolas Leymarie Brendan Le Picault Elie Fadel Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula Journal of Cardiothoracic Surgery Right bronchial fistula Pneumonectomy Carina surgery Amplatzer |
| title | Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula |
| title_full | Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula |
| title_fullStr | Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula |
| title_full_unstemmed | Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula |
| title_short | Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula |
| title_sort | surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula |
| topic | Right bronchial fistula Pneumonectomy Carina surgery Amplatzer |
| url | https://doi.org/10.1186/s13019-024-03285-7 |
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