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Closure of bronchopleural fistula by a septal occluder device: a case for close collaboration between heart and lung specialists
  1. Célia Marques Domingues1,
  2. Vitor Matos1,
  3. António Ferreira2,3,
  4. Elisabete Jorge1,2,
  5. João Bernardo4 and
  6. Lino Gonçalves1,3
  1. 1 Cardiology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  2. 2 Pneumology, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
  3. 3 Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
  4. 4 Cardiothoracic Surgery, Centro Hospitalar e Universitáriode Coimbra EPE, Coimbra, Portugal
  1. Correspondence to Célia Marques Domingues, celiadomingues{at}


We present the case of a 66-year-old woman who underwent right inferior lobectomy for pulmonary carcinoma and developed persistent bronchopleural fistula (BPF) that was not amenable to surgical intervention (two surgical failures). The patient presented with a persistent cough and dyspnoea, which was treated with a hybrid procedure using fluoroscopy and bronchoscopy. A 7 mm Amplatzer septal occluder device (ASOD) was successfully inserted into the BPF. Two weeks after the procedure, a small fistula developed, which was treated by endoscopically guided biologic glue embolisation. At 2-month, 6-month and 12-month follow-up visits, clinical examinations and endoscopic imaging confirmed the complete occlusion of the BPF. Obvious migration of the ASOD was not apparent, and the patient has remained asymptomatic. The success of an endoscopic BPF closure with the use of hybrid techniques was achieved because of a collaborative effort by a multidisciplinary team.

  • interventional cardiology
  • lung cancer (oncology)
  • cardiothoracic surgery
  • air leaks
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  • Contributors CMD was the primary author for writing the case and discussion. VM and AF were the primary interventionists on hybrid procedure and contributed to writing the case. EJ participated on procedure and edited the case report. JB edited the case and was the senior thoracic surgeon primarily responsible for the patient’s care. LG edited the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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