TY - JOUR
T1 - Surgery for chronic pyothorax after failed amplatzer closure of bronchopleural fistula
AU - Vincent, Yohann
AU - Lenzini, Alessandra
AU - Hanna, Amir
AU - Leymarie, Nicolas
AU - Le Picault, Brendan
AU - Fadel, Elie
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/12/1
Y1 - 2025/12/1
N2 - 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.
AB - 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.
KW - Amplatzer
KW - Carina surgery
KW - Pneumonectomy
KW - Right bronchial fistula
UR - http://www.scopus.com/inward/record.url?scp=85216058341&partnerID=8YFLogxK
U2 - 10.1186/s13019-024-03285-7
DO - 10.1186/s13019-024-03285-7
M3 - Article
C2 - 39819355
AN - SCOPUS:85216058341
SN - 1749-8090
VL - 20
JO - Journal of Cardiothoracic Surgery
JF - Journal of Cardiothoracic Surgery
IS - 1
M1 - 67
ER -