Subject(s)
Humans , Female , Aged , Bronchial Fistula , Pulmonary Artery , Angioplasty , Hypertension, Pulmonary , TherapeuticsSubject(s)
Aspergillosis , Bronchitis , Tracheitis , Aspergillosis/diagnosis , Aspergillus , Bronchitis/diagnosis , Humans , Tracheitis/diagnosisSubject(s)
Tracheal Stenosis , Endoscopy , Humans , Intubation, Intratracheal , Tracheal Stenosis/therapy , TracheostomySubject(s)
Angioplasty, Balloon , Fistula , Hypertension, Pulmonary , Pulmonary Embolism , Chronic Disease , Humans , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/etiology , Hypertension, Pulmonary/therapy , Pulmonary Artery/diagnostic imaging , Pulmonary Embolism/diagnosis , Pulmonary Embolism/etiology , Pulmonary Embolism/therapy , Treatment OutcomeSubject(s)
Bronchial Fistula/surgery , Bronchoscopy , Lung Transplantation/adverse effects , Pleural Diseases/surgery , Postoperative Complications/surgery , Septal Occluder Device , Bronchial Fistula/etiology , Female , Humans , Middle Aged , Pleural Diseases/etiology , Pneumonectomy/adverse effects , Postoperative Complications/etiologyABSTRACT
Anastomotic airway complications are a frequent cause of disease in lung transplantation. However, there is no consensus on the type of treatment to be performed with prosthetic devices. While some recent gadgets such as the Oki stent have been proposed for main right bronchus stenosis, there are no reports of stenting using this prosthesis in cases where the main complication is malacia rather than stenosis. We present 2 patients diagnosed with main right bronchus bronchomalacia, also involving bronchius intermedius. After several attempts to bypass the anastomosis employing different types of stent, including a T-tube Montgomery device, normal sputum drainage was not possible. Oki stenting was performed without complications, with a remarkable reduction in endoscopic procedures as well as important functional improvement. For both stenosis and bronchomalacia in lung transplantation, we propose Oki stenting as the first choice of treatment.
Subject(s)
Bronchomalacia/surgery , Lung Transplantation/methods , Stents , Bronchi/surgery , Bronchoscopy , Humans , Male , Middle Aged , Prosthesis Implantation/methodsABSTRACT
Airway complications after lung transplant are relatively common although the rates vary according to the different studies. Pathogenesis is diverse but the principal mechanism is usually bronchus intermedius ischemia in the post-transplant period. One major complication is bronchial stenosis, with relatively frequent involvement of the bronchus intermedius in the case of right lung transplantation. Various treatments have been proposed for bronchus intermedius stenosis, such as endobronchial balloon dilation, laser, cryosurgery and bronchial stents. We present two cases of lung transplant recipients with bronchus intermedius stenosis treated with a Montgomery stent or T-stent, commonly used for tracheal stenosis, who showed positive clinical and functional response.
Subject(s)
Bronchial Diseases/surgery , Lung Transplantation , Postoperative Complications/surgery , Stents , Bronchial Diseases/etiology , Bronchomalacia/diagnosis , Bronchomalacia/surgery , Constriction, Pathologic/etiology , Constriction, Pathologic/surgery , Equipment Design , Humans , Lung Diseases, Fungal/drug therapy , Male , Middle Aged , Reoperation , Surgical Wound Infection/drug therapyABSTRACT
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