Endoscopic Occlusion of Tracheoesophageal Fistula in Ventilated Patients Using an Amplatzer Septal Occluder

Acquired tracheoesophageal fistula (TEF) is a challenging, life threatening condition. It most commonly appears in critically ill patients requiring prolonged mechanical ventilation, who cannot withstand open neck or chest surgery. An endoscopic technique could be better tolerated by these patients....

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Bibliographic Details
Published in:Indian journal of otolaryngology, and head, and neck surgery and head, and neck surgery, 2015-06, Vol.67 (2), p.196-199
Main Authors: Cohen-Atsmoni, Smadar, Tamir, Akiva, Avni, Yona, Priel, Israel E., Roth, Yehudah
Format: Article
Language:English
Subjects:
Clinical Report
Endoscopy
Esophagus
Head and Neck Surgery
Medical disorders
Medicine
Medicine & Public Health
Otorhinolaryngology
Surgery
Surgical apparatus & instruments
Throat
Ventilation
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Summary:Acquired tracheoesophageal fistula (TEF) is a challenging, life threatening condition. It most commonly appears in critically ill patients requiring prolonged mechanical ventilation, who cannot withstand open neck or chest surgery. An endoscopic technique could be better tolerated by these patients. We present our experience using a cardiac Amplatzer ASD septal occluder for an endoscopic TEF repair in ventilation-dependent patients. Two high risk patients underwent the procedure under general anesthesia and close respiratory monitoring. In one patient the device was inserted through the trachea and in the other through the esophagus. In both cases fistula closure was achieved for different periods of time allowing the patients a temporary relief of symptoms. The procedure was well tolerated by the patients, and no significant adverse effect documented. The technique was successful as a temporary solution for unstable patients with TEFs and should be considered as a treatment modality for similar patients.
ISSN:2231-3796
0973-7707
DOI:10.1007/s12070-015-0842-7