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Tailored endoscopic treatment of tracheo-oesophageal fistula using preoperative holographic assessment and a cardiac septal occluder
  1. Stefano Siboni1,
  2. Angelo Fabio D'Aiello1,
  3. Massimo Chessa2,3 and
  4. Luigi Bonavina1,4
  1. 1Department of Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
  2. 2Department of Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
  3. 3Facoltà di Medicina e Chirurgia, Università Vita-Salute San Raffaele, Milano, Italy
  4. 4Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
  1. Correspondence to Professor Luigi Bonavina; luigi.bonavina{at}


Devices originally designed for closure of cardiac septal defects have also been proposed for the treatment of acquired tracheo-oesophageal fistula (TOF). Choosing the right occluder device to match TOF size and shape is essential for a tailored treatment. We report the successful endoscopic closure of a post-radiotherapy TOF using preprocedural CT scan with holographic three-dimensional reconstruction and an Amplatzer atrial septal device. Complete TOF sealing was achieved with resolution of respiratory symptoms, and the patient was maintaining his ability to eat at 4-month follow-up.

  • gastrointestinal system
  • respiratory system
  • endoscopy
  • oesophagus
  • oesophageal cancer

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  • Contributors SS and AFD'A wrote the manuscript, collected the data, and provided and cared for the study patient. MC and LB reviewed the manuscript and served as scientific advisors.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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