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Clinical Image
Bronchopleural Fistula Management With Amplatzer™ Insertion
Manejo de fístula broncopleural mediante colocación del dispositivo Amplatzer®
Ana Isabel Triviño Ramíreza,
Corresponding author
atrivi_17@hotmail.com

Corresponding author.
, Mercedes Merino Sánchezb, Cayo García Polob
a Servicio de Cirugía Torácica, Hospital Universitario Puerta del Mar, Cádiz, Spain
b Servicio de Neumología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 66-year-old patient with the following history&#58; right empyema on 2 occasions&#44; atypical resection for invasive adenocarcinoma &#40;1&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#41; in the left lower lobe&#44; atypical resection for squamous cell carcinoma &#40;2&#46;5<span class="elsevierStyleHsp" style=""></span>cm&#41; in the right upper lobe &#40;RUL&#41; 4 months later&#44; and decortication by thoracotomy&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Ten months after the last intervention&#44; due to suspected RUL recurrence on suture site&#44; right upper lobectomy with lymphadenectomy was completed&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">During the early postoperative period&#44; the patient presented dehiscence of the bronchial stump&#46; Despite reintervention&#44; fiberoptic bronchoscopy revealed persistent bronchopleural fistula &#40;BPF&#41; measuring 8<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mm in the RUL bronchial stump&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In view of the significant pleural thickening&#44; the size of the BPF&#44; and the small residual apical cavity&#44; we decided to perform a thoracostomy&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">After examining various therapeutic options&#44; we opted to close the BPF with an Amplatzer<span class="elsevierStyleSup">&#174;</span> Septal-Occluder device&#44; usually employed for foramen ovale closure&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The procedure was performed under sedation in the operating room&#46; The 10<span class="elsevierStyleHsp" style=""></span>mm Amplatzer<span class="elsevierStyleSup">&#174;</span> Septal-Occluder system guide was introduced via the thoracostomy incision&#44; and placed under simultaneous fiberoptic bronchoscopy visualization&#44; with no complications &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A and B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The patient&#39;s progress was satisfactory &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C and D&#41;&#44; and the thoracostomy could be closed after several months&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Trivi&#241;o Ram&#237;rez AI&#44; Merino S&#225;nchez M&#44; Garc&#237;a Polo C&#46; Manejo de f&#237;stula broncopleural mediante colocaci&#243;n del dispositivo Amplatzer<span class="elsevierStyleSup">&#174;</span>&#46; Arch Bronconeumol&#46; 2017&#59;53&#58;637&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Figures A and B show the moment when the system was placed&#58; &#40;A&#41; shows the view through the flexible fiberoptic bronchoscopy of the successful Amplatzer<span class="elsevierStyleSup">&#174;</span> placement&#44; after deployment&#46; &#40;B&#41; shows the view through the thoracostomy&#44; at the time of release of the Amplatzer<span class="elsevierStyleSup">&#174;</span> placement system&#46; Figures C and D show the results 3 months after placement&#58; &#40;C&#41; shows the view through the flexible fiberoptic bronchoscopy of the closed fistula in the RUL stump&#46; &#40;D&#41; shows the view through the thoracostomy&#46;</p>"
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                    0 => array:2 [
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                      "doi" => "10.1378/chest.07-1961"
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                        "tituloSerie" => "Chest"
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              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                          "autores" => array:4 [
                            0 => "J&#46;A&#46; Fern&#225;ndez-D&#237;az"
                            1 => "C&#46; Garc&#237;a-Gallo"
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                        "volumen" => "64"
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Article information
ISSN: 15792129
Original language: English
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