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Amplatzer Occluders for Effective Non-Surgical Management of Bronchopleural Fistulae.

Annals of Thoracic Surgery 2023 September 10
BACKGROUND: To assess the safety and efficacy of bronchopleural fistulae closure with Amplatzer occluder devices through our experience of over 14 years.

METHODS: Retrospective data review of patients from Rabin Medical Center who underwent Amplatzer occluder device placement between March 2007 and September 2021 for bronchopleural fistulae closure.

RESULTS: In total, 72 patients had 83 Amplatzer occluder devices implanted for bronchopleural fistulae closure. The median age was 65.5 (Q1, Q3; 56.0, 72.3). The primary diseases were lung malignancy and thoracic infection, 48(66.7%) and 9 (12.5%), respectively. Bronchopleural fistulae developed mainly following pneumonectomy (40.3%) and lobectomy (33.3%) with a median time from surgery to Amplatzer placement of 3.9 months (IQR 1.4 to 16.4). We encountered no procedural or immediate post-procedural complications or deaths. Six months following Amplatzer insertion, there were 7 (8.4%)Amplatzer removals and 11 (15.3%) fistula-related deaths.

CONCLUSIONS: Amplatzer occluders are a safe modality for non-surgical bronchopleural fistulae management with ease of placement under moderate sedation and flexible bronchoscopy with good short- and long-term effectivity.

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