Extracorporeal membrane oxygenator as a bridge to successful surgical repair of bronchopleural fistula following bilateral sequential lung transplantation: a case report and review of literature
| Autor: | N. Khasati, Nizar Yonan, Nouman U. Khan, Colm Leonard, A. Machaal, Mohamed Al-Aloul |
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| Rok vydání: | 2007 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Cystic Fibrosis Fistula medicine.medical_treatment lcsh:Surgery Bronchopleural fistula Case Report Postoperative Hemorrhage lcsh:RD78.3-87.3 Extracorporeal Membrane Oxygenation Extracorporeal membrane oxygenation Medicine Lung transplantation Humans business.industry lcsh:RD1-811 General Medicine Middle Aged Pleural Diseases medicine.disease Bronchial Fistula Surgery surgical procedures operative Respiratory failure lcsh:Anesthesiology Cardiothoracic surgery Cardiology and Cardiovascular Medicine business Airway Respiratory Insufficiency Lung Transplantation |
| Zdroj: | Journal of Cardiothoracic Surgery Journal of Cardiothoracic Surgery, Vol 2, Iss 1, p 28 (2007) |
| ISSN: | 1749-8090 |
| Popis: | Background Lung transplantation (LTx) is widely accepted as a therapeutic option for end-stage respiratory failure in cystic fibrosis. However, airway complications remain a major cause of morbidity and mortality in these patients, serious airway complications like bronchopleural fistula (BPF) are rare, and their management is very difficult. Case presentation A 47-year-old man with end-stage respiratory failure due to cystic fibrosis underwent bilateral sequential lung transplantation. Severe post-operative bleeding occurred due to dense intrapleural adhesions of the native lungs. He was re-explored and packed leading to satisfactory haemostasis. He developed a bronchopleural fistula on the 14th post-operative day. The fistula was successfully repaired using pericardial and intercostal vascular flaps with veno-venous extracorporeal membrane oxygenator (VV-ECMO) support. Subsequently his recovery was uneventful. Conclusion The combination of pedicled intercostal and pericardial flaps provide adequate vascular tissue for sealing a large BPF following LTx. Veno-venous ECMO allows a feasible bridge to recovery. |
| Databáze: | OpenAIRE |
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